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International Urogynecology Journal

Erschienen in:

27.01.2021 | Original Article

Symptoms of voiding dysfunction and other coexisting pelvic floor dysfunctions: the impact of transvaginal, mesh-augmented sacrospinous ligament fixation

verfasst von: Maren Himmler, Martin Kohl, Aidana Rakhimbayeva, Magdalena Witczak, Alexander Yassouridis, Bernhard Liedl

Erschienen in: International Urogynecology Journal | Ausgabe 10/2021

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Abstract

Introduction and hypothesis

The objective was to investigate the prevalence for voiding dysfunction and if symptom improvement can be achieved by adequate pelvic floor surgery.

Methods

We evaluated the Propel Study data from 281 women with pelvic organ prolapse (POP) stage 2–4. Bother caused by obstructive micturition, voiding dysfunction, and coexisting pelvic floor symptoms were assessed using the Pelvic Floor Distress Inventory (PFDI) preoperatively and 6, 12, and 24 months after vaginal prolapse repair. Successful reconstruction (Pelvic Organ Prolapse Quantification [POP-Q] stage 0–I throughout the 2-year follow-up at all compartments, “responders”), was compared with all others (“non-responders”).

Results

Prevalence of voiding dysfunction was significantly reduced after surgery for all patients with “moderate” to “quite a bit” of bother (“R2”) regarding all examined PFDI questions. Defects of the posterior/apical compartment and lower stage defects were found to cause obstructive micturition, which improved significantly after POP surgery. Six months after surgery, the prevalence of R2 for voiding dysfunction symptoms was reduced significantly for responders compared with non-responders. Significant reduction of R2 in patients with rectoceles could be shown for some PFDI questions, whereas the rate was lower in patients with cystoceles. Other pelvic floor symptoms often coexisted in patients with voiding dysfunction symptoms and improved significantly after surgery as well.

Conclusions

Symptoms of voiding dysfunction are frequent in female patients with POP and can significantly improve after vaginal mesh-augmented prolapse repair even for posterior and minor defects. Before counseling patients to undergo POP surgery because of their obstructive symptoms, other causes of voiding dysfunction must first have been ruled out.

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Titel: Symptoms of voiding dysfunction and other coexisting pelvic floor dysfunctions: the impact of transvaginal, mesh-augmented sacrospinous ligament fixation
verfasst von: Maren Himmler
Martin Kohl
Aidana Rakhimbayeva
Magdalena Witczak
Alexander Yassouridis
Bernhard Liedl
Publikationsdatum: 27.01.2021
Verlag: Springer International Publishing
Erschienen in: International Urogynecology Journal / Ausgabe 10/2021
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04649-y

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Symptoms of voiding dysfunction and other coexisting pelvic floor dysfunctions: the impact of transvaginal, mesh-augmented sacrospinous ligament fixation