Lower Urinary Tract Symptoms In Female Patients With Pelvic Organ Prolapse: Efficacy Of Pelvic Floor Reconstruction

ObjectiveTo evaluate the impact of pelvic floor reconstruction on lower urinary tract symptoms in patients with pelvic organ prolapse.MethodsWe carried out a prospective study at a single institution. A total of 223 female patients who underwent tension-free vaginal mesh surgery for pelvic organ prolapse between January 2006 and February 2010 were enrolled and prospectively evaluated. A total of 171 cases with concurrent stress urinary incontinence (76% of all cases) underwent concomitant transobturator tape sling. For evaluation of lower urinary tract symptoms, parameters included International Prostate Symptom Score, its quality of life score, International Consultation on Incontinence Questionnaires Short Form, overactive bladder questionnaire, maximal flow rate and postvoid residual. These parameters were evaluated at baseline, and at 3, 6 and 12months after the surgery.ResultsThe severity of International Prostate Symptom Score total scores significantly correlated with preoperative pelvic organ prolapse quantification stages, overactive bladder questionnaire total scores and International Consultation on Incontinence Questionnaires Short Form scores. A total of 37% of stage4 showed 20 International Prostate Symptom Score (severe cases). Postvoid residual significantly increased in stage4 compared with stage2. Tension-free vaginal mesh improved International Prostate Symptom Score, overactive bladder questionnaire and International Consultation on Incontinence Questionnaires Short Form significantly, and also achieved grade0 pelvic organ prolapse quantification in 91% of all cases at 1year after surgery. Postvoid residual values significantly improved and remained stable for 1year. Worse overactive bladder questionnaire score was a significant predictive factor for poor postoperative International Prostate Symptom Score.ConclusionThe tension-free vaginal mesh plus transobturator tape procedure improves lower urinary tract symptoms in the majority of patients presenting pelvic organ prolapse.