[Prospective study of the impact on lower urinary tract symptoms after pelvic organ prolapse surgery]

Abstract

Objective: To investigate effect of urinary conditions and lower urinary tract symptoms (LUTS) in patients before and after the reconstructive pelvic surgery (RPS) for pelvic organ prolapse (POP) as well as effect of urinary conditions and LUTS by tension-free vaginal tape-obturator (TVT-O).

Methods: From Jan. 2007 to Dec. 2009, 213 patients with POP underwent RPS, the factors on preoperative, postoperative urinary conditions and qualities of life and postoperative urinary incontinence were studied prospectively.

Results: Totally 193 patients who was followed up for more than 3 months after surgery attend questionnaires, and 165 preoperative patients of 193 (85.5%) had LUTS, 105 postoperative patients of 193 (54.4%) had LUTS, which reached statistical difference (P < 0.01). The rate of LUTS before and after operation: urinary frequency (57.0% and 25.9%), urinary urgency (51.8% and 28.0%), urinary leakage due to cough (50.3% and 15.0%), dropping urinary leakage (44.6% and 14.5%), dysuria (34.7% and 23.3%), vesicaltenesmus (49.2% and 19.7%) and hand assist urination (31.1% and 2.6%). The incidence of LUTS after surgery is much lower than that of pre-operation (P < 0.05). POP patients with stress urinary incontinence (SUI) before the operation, surgery without TVT-O simultaneously are the risk factors of unimproved symptom (OR = 4.933, 95%CI: 1.353 - 17.990, P = 0.016).

Conclusions: RPS have alleviated LUTS in patients with POP. RPS with TVT-O are more effective than traditional RPS in treatment of the urinary incontinence if the POP patient with SUI or occult SUI.