Abstract
It is well known that overactive bladder (OAB) symptoms are common in women who present for treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). Despite many studies showing that OAB is common in women who suffer from POP, there is no clear data to explain the causal relationship between OAB and POP. Although it has been theorized that repair of anterior compartment prolapse may improve OAB symptoms, the data is limited by the lack of clinical studies focusing on isolated anterior compartment repairs. There is data to suggest, however, that OAB symptoms can improve after prolapse repair, but as of yet, there have been no clear predictive factors that have been elucidated. Thus, it is reasonable to counsel women with OAB symptoms undergoing anterior compartment repair, or any isolated prolapse repair, that their OAB symptoms may or may not improve after prolapse repair.
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References
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Haylen B, de Ridder D, Freeman R, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.
Irwin D, Kopp A, Agatep B, et al. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108:1132–9.
Wennberg A, Molander U, Fall M, et al. Incontinence, overactive bladder, and other lower urinary tract symptoms in women. Eur Urol. 2009;55:783–91.
Hartmann KE, McPheeters ML, Biller DH, Ward RM, McKoy JN, Jerome RN, et al. Treatment of overactive bladder in women. Evid Rep Technol Assess. 2009; (187):1–120.
Coyne K, Revicki D, Hunt T, et al. Psychometric validation of an overactive bladder symptoms and health-related quality of life questionnaire: the OAB-q. Qual Life Res. 2002;11:563–74.
de Boer TA, Salvatore S, Cardozo L, et al. Pelvic organ prolapse and overactive bladder. Neurourol Urodyn. 2010;29(1):30–9.
Sajadi K, Vasavada S. Overactive bladder after sling surgery. Curr Urol Rep. 2010;11:366–71.
Baessler K, Maher C. Pelvic organ prolapse surgery and bladder function. Int Urogynecol J. 2013;24:1843–52.
Botros S, Miller JJR, Goldberg R, et al. Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings. Neurourol Urodyn. 2007;26:42–5.
Mahajan ST, Elkadry E, Kenton K, et al. Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynecol. 2006;194:722–8.
Cetinkaya S, Dokmeci F, Dai O. Correlation of pelvic organ prolapse staging with lower urinary tract symptoms, sexual dysfunction and quality of life. Int Urogynecol J. 2013;24:1645–50. Recent prospective study that showed a correlation between POP-Q staging and lower urinary tract questionnaires UDI-6 and IIQ-7.
Bump R, Mattiasson A, Bo K, et al. The standardization of terminology of female organ prolapse and pelvic floor. Am J Obstet Gynecol. 1996;175(1):10–7.
Yuan ZY, Shen H. Pelvic organ prolapse quantification in women referred with overactive bladder. Int Urogynecol J. 2010;21:1365–9.
Coyne K, Matza L, Thompson C, et al. Determining the importance of change in the overactive bladder questionnaire. J Urol. 2006;176(2):627–32.
Salvatore S, Serati M, Ghezzi F, et al. Efficacy of tolterodine in women with detrusor overactivity and anterior vaginal wall prolapse: is it the same? BJOG. 2007;114:1436–8.
Chin HY, Chiang CH, Lin KC, et al. Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advances vaginal wall prolapse: a preliminary report. J Obstet Gynaecol Res. 2009;35(4):732–7.
Okui N, Okui M, Horie S. Improvements in overactive bladder syndrome after polypropylene mesh surgery for cystocele. Aust N Z J Obstet Gynaecol. 2009;49:226–31.
Ek M, Altman D, Falconer C, et al. Effects of anterior trocar guided transvaginal mesh surgery on lower urinary tract symptoms. Neurourol Urodyn. 2010;29:1419–23.
Basu M, Duckett J. The association of changes in opening detrusor pressure with the resolution of overactive bladder symptoms after repair of pelvic organ prolapse. Neurourol Urodyn. 2011;30:595–8.
Digesu GA, Salvatore S, Chaliha C, et al. Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J. 2007;18:1439–43.
Miranne J, Lopes V, Carberry C, Sung V. The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery. Int Urogynecol J. 2013;24:1303–8. This retrospective study looked at the relationship between preoperative POP-Q and bother from urinary frequency and urge incontinence using the PFDI. It was suggested that women with higher-stage POP-Q preoperatively had a higher likelihood of persistent postoperative urinary frequency and urge incontinence.
Dieter AA, Edenfield AL, Weidner AC, Siddiqui N. How does site of pelvic organ prolapse repair affect overactive bladder symptoms? Female Pelvic Med Reconstr Surg. 2014;20(4):203–7. This retrospective study compared the improvement in postoperative OAB-q scores in women undergoing anterior/apical vaginal repair to those undergoing posterior vaginal repair. This study showed that improvement in OAB-q scores improved in all patients regardless of which compartment was repaired.
Fletcher S, Haverkorn R, Lee J, et al. Demographic and urodynamic factors associated with persistent OAB after anterior compartment prolapse repair. Neurourol Urodyn. 2010;29:1414–8.
Lee DM, Ryu YW, Lee YT, et al. A predictive factor in overactive bladder symptoms improvement after combined anterior vaginal wall prolapse repair. Korean J Urol. 2012;53:405–9.
Duckett J, Chakani D. The effect of prolapse repair on urinary flow rates and the relationship to changes in the ultrasound appearance of the bladder neck. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):372–5.
Long CY, Hsu CS, Wu MP, et al. Predictors of improved overactive bladder symptoms after transvaginal mesh repair for treatment of pelvic organ prolapse. Int Urogynecol J. 2011;22:535–42.
Wolter CE, Kaufman MR, Duffy JW, et al. Mixed incontinence and cystocele: postoperative urge symptoms are not predicted by preoperative urodynamic. Int Urogynecol J. 2011;22:321–5.
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;197:82.e1–4.
Deiter AA, Edenfield AL, Weidner AC, et al. Does concomitant anterior/apical repair during midurethral sling improve the overactive bladder component of mixed incontinence? Int Urogynecol J. 2014;25:1269–75. This retrospective study compared OAB-q scores in women who underwent midurethral sling to those who underwent midurethral sling with concomitant anterior/apical vaginal prolapse repair. There was no difference in the level of postoperative improvement in OAB-q scores in the two groups, suggesting that anterior/apical compartment repair may not have much impact on OAB symptoms.
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Cynthia Fok declares that she has no conflict of interest.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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Fok, C.S. Does Cystocele Repair Improve Overactive Bladder Symptoms?. Curr Bladder Dysfunct Rep 10, 1–5 (2015). https://doi.org/10.1007/s11884-014-0284-1
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DOI: https://doi.org/10.1007/s11884-014-0284-1