DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205233

Comparative evaluation of urodynamic profile in cases of cystocele alone or associated with uterovaginal prolapse before and after surgery

Paridhi Garg, Bani Sarkar

Abstract


Background: Pelvic organ prolapse is a bulge or protrusion of pelvic organs and their associated vaginal segments into or through the vagina. There may be structural and functional changes in the bladder and urethra post-operatively.

Methods: It was a prospective type of cohort study. The study was conducted on 30 patients with cystocele with or without uterovaginal prolapse undergoing surgery for same under Department of Obstetrics and Gynecology of Dr. Ram Manohar Lohia Hospital. Comparison of various pre-operative and post-operative urodynamic parameters were done using appropriate statistical tests.

Results: Post-operatively, statistically significant increase was observed in the bladder volumes at which patients had first and strong desire to void as well as in the maximum cystometric capacity, increase in mean compliance, increase in mean average flow rate, decrease in post-void residual volume. Though, no significant improvement was seen on peak flow rates on uroflowmetry, maximum filling detrussor pressure, mean peak flow rates, maximum voiding detrussor pressure, mean detrussor pressure at peak flow rate.

Conclusions: A pre-operative urodynamic study may be helpful in planning the site-specific repair surgery. It will also help in predicting the post-operative outcome. Urge related symptoms may not be corrected by cystocele repair alone and may require additional treatment.


Keywords


Urodynamic study, Cystocele, Uterovaginal prolapse, Pelvic organ prolapse

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References


Ballard AV, Meyer I, Varner RE, Gleason JL, Richter HE. Pelvic Organ Prolapse. In: Berek & Novak’s Gynecology. 15th edition. Lippincott Williams &Wilkins. 2012;906-39.

Pelvic organ prolapse. ACOG. Technical Bulletin. Int J Gynecol Obstet. 1996;52:197-205.

Jackson SL, Weber AM, Hull TL, Mitchinson AR, Walters MD. Incontinence in women with Pelvic Organ Prolapse. Int J Gynecol Obstet. 1997;89:423-7.

Miklos JR. Uroflowmetry. In: Clinical Urogynecology. 2nd edition. Churchill Livingstone. 2000;118-24.

Michael B Chancellor, Rivas DA, Mulholland SG, Drake Jr WM. The Invention of the Modern Uroflowmeter by Willard M Drake, Jr at Jefferson Medical College. Urol. 1998;51(4):671-4.

Miklos JR. Cystometry and videocystourethrography. In: Clinical Urogynecology. 2nd edition. Churchill Livingstone. 2000;95-96.

Panicker R, Sriniwas S. Urodynamic changes in pelvic organ prolapse and the role surgery. Medic J Arm Forc Ind. 2009;65:221-4.

Wolter CE, Kaufman MR, Duffy JW, Scarpero HM, Dmochowski RR. Mixed incontinence and cystocoele: postoperative urge symptoms are not predicted by preoperative urodynamics. Int Urogynecol J. 2011;22(3):321-5.

Wall LL, Hewitt JK. Urodynamic characteristics of women with complete post hysterectomy vaginal vault prolape. Urology. 1994;44(3):336-41.

Chaikin DC, Groutz A, Blaivas JG. Predicting the need for anticholinergics for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapsed. J Urol. 2000;163(2):531-4.