Voiding dynamics of pelvic organ prolapse: Large scale comparative study

Abstract

AbstractPurposeTo determine the voiding dynamics of the patients with pelvic organ prolapse (POP).Materials and methodsA retrospective patient file review was performed of 877 female patients with lower urinary tract symptoms. After exclusion criteria 373 female patients were eligible for the study. Two patient groups w/wo prolapse were identified. The symptoms, patient characteristics, patterns of free urine flow, and detrusor voiding pressure curves were compared between two groups. A comparison of the urodynamic findings between the subgroups (mild/moderate, severe, and w/o prolapse) was made and shown on a scatter plot graphics of PdetQmax versus Qmax as well.ResultsA total of 373 patients with median age 54 (18–92), 189 (51%) had varying degrees and forms of POP while 184 (49%) did not have any prolapse (p < 0.003). Logistic regression analysis results showed that older age [p = 0.023, odds ratio (OR) = 1.01, confidence interval (CI): (1.00–1.03)], weaker pelvic floor muscle strength [p = 0.032, OR = 1.67, CI: (1.04–2.69)], more frequent symptom of hesitancy [p = 0.003 OR = 2.15 CI: (1.29–3.58)], prolonged‐tailed shaped curve pattern of free urine flow [p = 0.027 OR = 1.97 CI: (1.08–3.58)], and higher PdetQmax (22 cmH2O) values [p = 0.002, OR = 1.02, CI: (1.00–1.03)] were the independent different features of the patients with prolapse. Subgroup urodynamic analysis showed significantly lower free flowmetry Qmax and higher PdetQmax values in patients with severe prolapse. Prolonged/tailed‐shaped curve pattern of free urine flow was significantly more frequent in patients with prolapse.ConclusionsVoiding dynamics of the patients with prolapse were significantly different from the patients' w/o prolapse. They had higher PdetQmax values, more frequent symptom of hesitancy, and prolonged shaped free flow curve pattern. Free flow Qmax values were lower in patients with severe prolapse.