A predictive factor in overactive bladder symptoms improvement after combined anterior vaginal wall prolapse repair: a pilot study

Korean J Urol. 2012 Jun;53(6):405-9. doi: 10.4111/kju.2012.53.6.405. Epub 2012 Jun 19.

Abstract

Purpose: We aimed to determine whether a preoperative urodynamic parameter is a valuable predictor for the persistence of OAB symptoms after the AVP repair.

Materials and methods: 65 OAB patients with concomitant POP-Q stage III, IV anterior vaginal wall prolapse underwent a surgical repair were involved. All the patients were subjected to a preoperative urodynamic study, for whom the OABSS on questionnaire were preoperatively recorded. We firstly analyzed the correlation between the BOOI and the OABSS, then randomly divided patients into two groups: the group A (high PdetQmax, BOOI≥20) and the group B (low PdetQmax, BOOI<20). In each group, the OABSS was repeatedly measured post-operatively and the change were analyzed.

Results: 31 patients were classified as the group A and 34 patients were classified as the group B. The group B showed significant decrease of symptom score in daytime frequency (p<0.01), urgency (p=0.04), urge incontinence (p=0.03), nocturnal frequency (p=0.01) and total score (p=0.01). The group A showed no significant decrease of symptom score in daytime frequency (p=0.42), urgency (p=0.61), urge incontinence (p=0.3), total score (p=0.15) except nocturnal frequency (p=0.01).

Conclusions: A preoperative pressure-flow study can be a valuable tool in predicting the OAB symptoms change after the combined AVP repair. While the AVP repair leads to the improvement of OAB symptoms generally, some patients with a higher preoperative PdetQmax are still in need of the additional medical treatment.

Keywords: Pelvic organ prolapse; Urinary bladder, overactive.