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Inicio Actas Urológicas Españolas (English Edition) Post-void residual and voiding dysfunction symptoms in women with pelvic organ p...
Journal Information
Vol. 45. Issue 1.
Pages 57-63 (January - February 2021)
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Vol. 45. Issue 1.
Pages 57-63 (January - February 2021)
Original article
Post-void residual and voiding dysfunction symptoms in women with pelvic organ prolapse before and after vaginal surgery. A multicenter cohort study
Residuo posmiccional y síntomas de disfunción de vaciado en mujeres con prolapso de órganos pélvicos antes y después de la cirugía vaginal. Estudio de cohortes multicéntrico
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M. Espuña Ponsa,
Corresponding author
mespuna@clinic.cat

Corresponding author.
, J. Cassadób, I. Díez Itzac, E.M. Valero Fernándezd
a Unidad de Uroginecología, ICGON, Hospital Clínic de Barcelona, Barcelona, Spain
b Hospital Universitari Mutua Terrassa, Terrassa, Spain
c Hospital Universitario Donostia, San Sebastián, Spain
d Departamento Médico, Astellas Pharma S.A., Madrid, Spain
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Tables (4)
Table 1. Description of the sociodemographic and clinical characteristics of the patients at the baseline visit.
Table 2. Classification of POP according to type and grade.
Table 3. Relationship and results of the VPR volume obtained by catheterization based on to the presence or absence of voiding dysfunction symptoms according to EPIQ.
Table 4. Distribution of patients according to the type of intervention.
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Abstract
Objectives

The present study evaluates the impact of vaginal surgery for pelvic organ prolapse (POP) on voiding dysfunction (VD) symptoms and post-void residual (PVR) one year after the intervention.

Material and methods

Epidemiological, longitudinal, prospective study. Thirty-nine gynecology units included women with symptomatic POP grade 2 or higher according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who would undergo surgery for vaginal prolapse (CIRPOP-IUE study). Sociodemographic and clinical variables were collected before and after the intervention. At both visits, patients completed the ‘Epidemiology of Prolapse and Incontinence Questionnaire’ (EPIQ) and ‘Pelvic Floor Distress Inventory’ (PFDI-20) questionnaire. PVR volume was measured by bladder catheterization immediately after spontaneous urination.

Results

VD symptoms were present in 50% cases before the intervention. PVR was measured in 277 women of which 116 (41.87%) were >50ml and 42/277 (15.2%) were >100ml. Objective and subjective reduction in VD symptoms was observed one year after the intervention. Mean PVR volume was reduced with statistical significance, from a mean (SD) of 66.4 (68.9)ml to 48.3 (51.3)ml. The number of patients who reported difficulty in emptying and sensation of incomplete emptying on the EPIQ and PFDI-20 questionnaires also decreased.

Conclusions

In general, improved voiding functions were observed in the CIRPOP-IUE study through a decrease in specific VD symptoms and a reduction in mean PVR volume.

Keywords:
Pelvic organ prolapse
Urinary incontinence
Surgery
Woman
Voiding dysfunction
Resumen
Objetivos

El presente trabajo evalúa el impacto de la cirugía vaginal del prolapso de órganos pélvicos (POP) en los síntomas de disfunción de vaciado (DV) y en el residuo posmiccional (RPM) un año después de la intervención.

Material y métodos

Estudio epidemiológico, longitudinal y prospectivo. Un total de 39 unidades de ginecología incluyeron mujeres con POP sintomático de grado 2 o superior según la clasificación Pelvic Organ Prolapse Quantification (POP-Q) que iban a ser sometidas a cirugía del prolapso por vía vaginal (estudio CIRPOP-IUE). Se recogieron variables sociodemográficas y clínicas antes y después de la intervención. En ambas visitas, las pacientes cumplimentaron los cuestionarios Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ) y Pelvic Floor Distress Inventory (PFDI-20). El RPM se midió por sondaje vesical inmediatamente después de una micción espontánea.

Resultados

El 50% de las mujeres refirieron síntomas de DV antes de la intervención. El RPM se midió en 277 mujeres de las cuales en 116 (41,87%) fue >50ml y en 42/277 (15,2%) fue >100ml. Un año tras la intervención, se observó una reducción objetiva y subjetiva de los síntomas de DV. El RPM medio se redujo de forma estadísticamente significativa, pasando de una media (DE) de 66,4 (68,9)ml a 48,3 (51,3)ml. También disminuyó el número de pacientes que reportaron dificultad de vaciado y sensación de vaciado incompleto en los cuestionarios EPIQ y PFDI-20.

Conclusiones

En general, se observó una mejora de la función miccional tanto a través de la disminución de los síntomas específicos de DV como de la reducción del volumen medio del RPM.

Palabras clave:
Prolapso de órganos pélvicos
Incontinencia urinaria
Cirugía
Mujer
Disfunción del vaciado vesical

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