Pelvic Organ Prolapse Associated With Stress Urinary Incontinence in Perimenopausal and Postmenopausal Women With Urodynamic Study

Abstract

Objective To explore the clinical and urodynamic features of pelvic organ prolapse (POP) and its relationship with stress urinary incontinence (SUI). Methods From January 2003 to December 2006, 108 cases of perimenopausal and postmenopausal women, hospitalized in the Department of Obstetrics and Gynecology, GongLi Hospital, were admitted with stress urinary incontinence or pelvic organ prolapse surgeries, who had the urodynamic test aimed to evaluate prolapse based on the pelvic organ prolapse quantification (POP-Q) system, including the test of abdominal leak point pressure (ALPP), functional urethral length (FUL), maximal urethral closure pressure (MUCP), and maximal urethral pressure (MUP). Informed consent was obtained from all the participates. Results Among pelvic organ prolapse patients, stress urinary incontinence cases accounted for 68.5% (74/108). In terms of abdominal leak point pressure, the positive rate was 71.4% (70/98) in the pelvic organ prolapse patients who had participated in the urodynamic test. For functional urethral length, maximal urethral pressure, and maximal urethral closure pressure, significant decrease was identified in patients with pelvic organ prolapse. As to the abdominal leak point pressure among patients with and without stress urinary incontinence, the positive rates were 87.1% and 32.1%, respectively. In patients with uterine prolapse, the abdominal leak point pressure significantly increased over others. Taken of pressures at the abdominal leak point to evaluate, the incidence of occult stress urinary incontinence in pelvic organ prolapse patients would be 9.2% (9/98). There was no statistical difference in functional urethral length, maximal urethral pressure, and maximal urethral closure pressure between patients with stress urinary incontinence or not(P>0.05). Conclusion It is necessary to carry out preventive stress urinary incontinence correction operation for pelvic organ prolapse patients without clinical symptoms of stress urinary incontinence, in the condition of shorter functional urethral length, low maximal urethral closure pressure, and maximal urethral pressure value. Key words: pelvic organ prolapse (POP); stress urinary incontinence(SUI); abdominal leak point pressure(ALPP); functional urethral length (FUL); maximal urethral pressure(MUP); maximal urethral closure pressure(MUCP)