The association of changes in opening detrusor pressure with the resolution of overactive bladder symptoms after repair of pelvic organ prolapse

Abstract

To evaluate whether changes in opening detrusor pressure (ODP) are associated with resolution of overactive bladder symptoms in women undergoing surgical correction of pelvic organ prolapse. Forty women with DO and OAB together with anterior wall prolapse who underwent a repair between 2003 and 2007 were studied. Each woman was assessed pre- and post-operatively with a clinical assessment and cystometry. Opening pressures were recorded pre- and post-operatively for each patient by retrospective review of the pressure flow traces. Patients were divided into those who experienced resolution of OAB symptoms and those with persistent OAB symptoms. Wilcoxon matched pairs signed rank test was used to assess any change in opening pressures between these groups. Resolution of urgency with an anterior repair was associated with a significant fall in ODP from a mean of 27.9 to 11.7 cmH(2)O (P = 0.01). There was no significant pre-operative difference in ODP between women in whom urgency resolved and those in whom it did not. These results suggest that a fall in ODP is associated with resolution of urgency in women undergoing prolapse surgery. This may imply that decreased urethral resistance is of importance in symptom resolution.