Assessment of overactive bladder symptoms among women with successful pessary placement.

Abstract

The causal association between pelvic organ prolapse (POP) and overactive bladder (OAB) symptoms is supported by several theories. The aim of this study is to assess any changes in OAB symptoms among women with POP and OAB after successful pessary placement. During the study period, all women with symptomatic POP stage II or greater and OAB symptoms were offered the solution of either a ring or a Gellhorn pessary. All patients were asked to complete a 3-day micturition/incontinence diary. Objective evaluation endpoints at baseline and at 6weeks included: change in the mean number of micturitions/24h, change in the mean volume voided per micturition/24h, and change in the number of urinary incontinence episodes. Subjective evaluation of the urgency, frequency, and nocturia symptoms was carried out using the score change of the questions 3, 5, and 2 of the International Consultation on Incontinence Questionnaire for Evaluating Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) respectively. Seventy-four women were included in the study. A statistically significant decrease (-28.3%; p<0.001) of the mean number of micturitions/24h with a significant increase (37%; p<0.001) in the mean voided volume per micturition/24h was observed. The total urine volume/24h remained unchanged. The number of urinary incontinence episodes was significantly increased 6weeks after pessary placement (p<0.001). De novo stress urinary incontinence (SUI) was reported by 16.7% of the initially stress continent women. Women with coexisting POP and OAB symptoms may experience a significant improvement in micturition frequency and in urgency and frequency symptoms after successful pessary fitting.