The incidence of low-pressure urethra as a function of prolapse-reducing technique in patients with massive pelvic organ prolapse (maximum descent at all vaginal sites)

American Journal of Obstetrics and Gynecology
D K VeronikisM M Wakamatsu

Abstract

Our aims were to compare several prolapse-reducing techniques during urodynamic evaluation and prospectively evaluate their usefulness in identifying the incidence of low urethral closure pressure in continent patients with massive prolapse. This preoperative, prospective, repeated-measures urodynamic study evaluated the maximum urethral closure pressure with the use of four different techniques in 30 consecutive continent patients with grade 4 prolapse at all vaginal sites. Twenty patients with grade 0 prolapse served as the control group. All patients from the prolapse group underwent surgical treatment and were followed up clinically for a minimum of 1 year. Use of the Scopette (Birchwood Laboratories, Eden Prairie, Minn.) reduction technique to reduce the prolapse in a linear orientation during multichannel urodynamics revealed a 56% incidence of low-pressure urethra and an overall genuine stress urinary incontinence of 83% in patients with massive pelvic organ prolapse but without clinical urinary incontinence. There may be an increased indication for sling urethropexy in patients with massive prolapse.

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Citations

Jul 31, 2013·International Urogynecology Journal·Stavros AthanasiouAris Antsaklis
Jun 27, 2002·Current Urology Reports·K C Kobashi, G E Leach
Nov 27, 2009·International Urogynecology Journal·Ellen BorstadSigurd Kulseng-Hanssen
Sep 8, 2010·International Urogynecology Journal·Sushma SrikrishnaLinda Cardozo
Sep 20, 2011·International Urogynecology Journal·Mark Malak
Feb 10, 2010·Journal de gynécologie, obstétrique et biologie de la reproduction·B Fatton, C Nadeau
Nov 5, 2013·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Ting-Chen ChangHo-Hsiung Lin
Feb 10, 2004·The Journal of Urology·Serge P Marinkovic, Stuart L Stanton
Nov 4, 2000·The Journal of Urology·K C Kobashi, G E Leach
Jan 23, 1999·The Journal of Urology·L J RomanziJ G Blaivas
Jul 20, 2007·Neurourology and Urodynamics·Ingrid NygaardUNKNOWN Pelvic Floor Disorders Network
Sep 6, 2005·Current Opinion in Obstetrics & Gynecology·Alexandra L HaesslerNarender N Bhatia
May 8, 2019·Neurourology and Urodynamics·Autumn EdenfieldSteven Swift
Apr 13, 2002·BJOG : an International Journal of Obstetrics and Gynaecology·Alex C Wang, Min-Chi Chen
Nov 18, 1998·Current Opinion in Obstetrics & Gynecology·V Khullar, L Cardozo
Jan 11, 2008·International Urogynecology Journal and Pelvic Floor Dysfunction·Anthony G ViscoUNKNOWN Pelvic Floor Disorders Network

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