The Relevance of Urodynamic Study in Genitourinary Prolapse with Special Reference to Genuine Stress Incontinence

Abstract

Pelvic Organ Prolapse (POP) Is A Complex Condition Often Associated With Both Urinary Incontinence And Urinary Retention. The Urodynamic Study Can Detect The Presence Or Absence Of Incontinence In Prolapse Patient & Type Of Surgery Appropriate For Particular Patient For Best Postoperative Outcome. Aims & Objectives: The aim of this study was to find out the voiding abnormalities among the prolapsed patient and to select the optimal surgical procedure in the individual patient based on the urodynamic findings. Methods: Fifty (50) patients attending gynaecology outdoor with any degree of pelvic organ prolapse fulfilling both inclusion and exclusion criteria are included in this study after taking proper written consent. Pessary test to detect occult stress urinary incontinence is performed. Routine investigation & USG were done. Then at urology department URODYNAMIC STUDY was performed. Transobturator tape surgery is used as an incontinence surgery. Results: Age distribution in our study population shows that maximum number (18, 36%) of patients were in the age group 61-70 years while minimum number (04, 08%) was noted in the age group above age group was found as above 70 years.Out of 50 patients only 40% of patient expressing symptom of SUI where as 60% patient had no symptom of SUI. 14% of patients in the study population attending in G&O OPD are in POP-Q stage II, stage III patient accounts for 54% while remaining 32% patients were in stage IV.Majority of patient (74%) of POP were suffering from stress urinary incontinence. Urge incontinence accounted for about 10% while 16% of patients had mixed form of incontinence.Our study showed 40% of patient of POP were suffering from overt stress urinary incontinence. And SUI could be detected in another 14% of prolapse patient after prolapse reduction by Pessary test.After doing Urodynamic study with prolapse reduction all prolapse patient with stress urinary incontinence could be detected. In the present study, incontinence surgery along with vaginal hysterectomy was done in 37 patients diagnosed stress urinary incontinence urodynamically. Only vaginal hysterectomy done in 13 patients diagnosed urge or mixed incontinence urodynamically.