Effect of prolapse repair on voiding and bladder overactivity

Abstract

POP repair (surgery/ring pessary) has a positive effect on the resolution of OAB, detrusor overactivity and voiding dysfunction, providing a theory for a causal effect between the conditions. Larger prospective observational studies are needed.

Predictors of persistent detrusor overactivity in women with pelvic organ prolapse following transvaginal mesh repair

“…The cure rate for OAB after non‐mesh POP surgery ranges from 45% to 82% . POP repair also has a positive effect on the resolution of DO and other voiding dysfunctions . In recent years, TVM repair has become one option for improving outcomes of pelvic reconstructive surgery, despite insufficient evidence on the long‐run safety.…”

“…5,8,16,18,23 POP repair also has a positive effect on the resolution of DO and other voiding dysfunctions. 16,18,23,24 In recent years, TVM repair has become one option for improving outcomes of pelvic reconstructive surgery, despite insufficient evidence on the long-run safety. Our results showed that 70% of DO and more than 50% of urgency and urgency incontinence disappeared after prolapse repair surgery, which is consistent with previous reports.…”

Predictors for detrusor overactivity following extensive vaginal pelvic reconstructive surgery

“…The most commonly accepted pathophysiology when prolapse is involved is of the increased bladder outlet obstruction or resistance. This is supported when the correction of POP improves voiding function, which is associated with a reduction in OAB …”

“…DO is subdivided into idiopathic detrusor overactivity and neurogenic detrusor overactivity. The ICS 2002 report describes two types of DO: (1) phasic, which may or may not lead to urinary incontinence and (2) terminal, which is a single involuntary detrusor contraction that often results in complete bladder emptying. A presumptive diagnosis of OAB can be made with a careful history and physical examination.…”

Conservative Management and Behavioral Modifications for Overactive Bladder

“…Placement in a patient with prolapse may relieve symptoms that may be secondary to poor emptying from outlet obstruction [33]. It is theorized that prolapse and chronic outlet obstruction lead to denervation of the bladder, thereby making the bladder supersensitive to acetylcholine.…”