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A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse.
Am J Obstet Gynecol. 2007 Jul; 197(1):82.e1-4.AJ

Abstract

OBJECTIVE

The objective of this study was to evaluate the impact of transvaginal prolapse surgery on overactive bladder symptoms in elderly women.

STUDY DESIGN

Women (> or = 65 years old) with stage III or IV prolapse who enrolled in a prospective study that compared vaginal reconstructive surgery (n = 39) to obliterative surgery (n = 26) and who underwent preoperative urodynamics are the subjects of this study. The women completed the Pelvic Floor Distress Inventory at baseline and again 6 months and 12 months after surgery. Postoperative changes in symptoms of urinary urgency, frequency, and urge urinary incontinence were assessed. The association between a baseline urodynamic diagnosis of detrusor overactivity and pre- and postoperative overactive bladder symptoms was also determined.

RESULTS

Data were analyzed from 65 subjects with a mean age of 75.3 years (range, 65.5-87.0 years). Detrusor overactivity was documented in 25% of subjects. There was no difference in the proportion of baseline urge incontinence (P = .38), urinary frequency (P = .53), or urgency (P = .76) in comparing women with and without detrusor overactivity. Surgery resulted in a significant reduction of urgency and frequency symptoms 6 months after surgery and a similar significant reduction in urgency and urge incontinence at 1 year after surgery. Overall, a clinically and statistically significant improvement in the irritative subscale of the Pelvic Floor Distress Inventory was noted at 6 months (18.3%; P < .0001) and 12 months (17.6%; P < .0001) after surgery. In our cohort, performance of a mid urethral sling, a bladder neck sling, or a Kelly plication was not associated with a reduction in postoperative symptoms of urgency, frequency, or urge incontinence (P = .48). Likewise, there was no difference in postoperative symptom reduction (urgency, frequency, or urge incontinence) between women who received reconstructive surgery vs women who had obliterative surgery (P = .84).

CONCLUSION

Vaginal surgery for stage III or IV pelvic organ prolapse significantly reduces overactive bladder symptoms in elderly women. In our cohort, symptom reduction was unrelated to the type of vaginal surgery (obliterative vs reconstructive) or the inclusion of a procedure to treat stress incontinence. Furthermore, preoperative urodynamic findings did not correlate with the presence or absence of overactive bladder symptoms.

Authors+Show Affiliations

Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

17618768

Citation

Foster, Raymond T., et al. "A Prospective Assessment of Overactive Bladder Symptoms in a Cohort of Elderly Women Who Underwent Transvaginal Surgery for Advanced Pelvic Organ Prolapse." American Journal of Obstetrics and Gynecology, vol. 197, no. 1, 2007, pp. 82.e1-4.
Foster RT, Barber MD, Parasio MF, et al. A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. Am J Obstet Gynecol. 2007;197(1):82.e1-4.
Foster, R. T., Barber, M. D., Parasio, M. F., Walters, M. D., Weidner, A. C., & Amundsen, C. L. (2007). A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. American Journal of Obstetrics and Gynecology, 197(1), e1-4.
Foster RT, et al. A Prospective Assessment of Overactive Bladder Symptoms in a Cohort of Elderly Women Who Underwent Transvaginal Surgery for Advanced Pelvic Organ Prolapse. Am J Obstet Gynecol. 2007;197(1):82.e1-4. PubMed PMID: 17618768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. AU - Foster,Raymond T,Sr AU - Barber,Matthew D, AU - Parasio,Marie Fidela R, AU - Walters,Mark D, AU - Weidner,Alison C, AU - Amundsen,Cindy L, PY - 2006/07/17/received PY - 2007/01/02/revised PY - 2007/02/27/accepted PY - 2007/7/10/pubmed PY - 2007/9/7/medline PY - 2007/7/10/entrez SP - 82.e1 EP - 4 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 197 IS - 1 N2 - OBJECTIVE: The objective of this study was to evaluate the impact of transvaginal prolapse surgery on overactive bladder symptoms in elderly women. STUDY DESIGN: Women (> or = 65 years old) with stage III or IV prolapse who enrolled in a prospective study that compared vaginal reconstructive surgery (n = 39) to obliterative surgery (n = 26) and who underwent preoperative urodynamics are the subjects of this study. The women completed the Pelvic Floor Distress Inventory at baseline and again 6 months and 12 months after surgery. Postoperative changes in symptoms of urinary urgency, frequency, and urge urinary incontinence were assessed. The association between a baseline urodynamic diagnosis of detrusor overactivity and pre- and postoperative overactive bladder symptoms was also determined. RESULTS: Data were analyzed from 65 subjects with a mean age of 75.3 years (range, 65.5-87.0 years). Detrusor overactivity was documented in 25% of subjects. There was no difference in the proportion of baseline urge incontinence (P = .38), urinary frequency (P = .53), or urgency (P = .76) in comparing women with and without detrusor overactivity. Surgery resulted in a significant reduction of urgency and frequency symptoms 6 months after surgery and a similar significant reduction in urgency and urge incontinence at 1 year after surgery. Overall, a clinically and statistically significant improvement in the irritative subscale of the Pelvic Floor Distress Inventory was noted at 6 months (18.3%; P < .0001) and 12 months (17.6%; P < .0001) after surgery. In our cohort, performance of a mid urethral sling, a bladder neck sling, or a Kelly plication was not associated with a reduction in postoperative symptoms of urgency, frequency, or urge incontinence (P = .48). Likewise, there was no difference in postoperative symptom reduction (urgency, frequency, or urge incontinence) between women who received reconstructive surgery vs women who had obliterative surgery (P = .84). CONCLUSION: Vaginal surgery for stage III or IV pelvic organ prolapse significantly reduces overactive bladder symptoms in elderly women. In our cohort, symptom reduction was unrelated to the type of vaginal surgery (obliterative vs reconstructive) or the inclusion of a procedure to treat stress incontinence. Furthermore, preoperative urodynamic findings did not correlate with the presence or absence of overactive bladder symptoms. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/17618768/A_prospective_assessment_of_overactive_bladder_symptoms_in_a_cohort_of_elderly_women_who_underwent_transvaginal_surgery_for_advanced_pelvic_organ_prolapse_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(07)00286-4 DB - PRIME DP - Unbound Medicine ER -