ABSTRACT
Background: Hysterectomy is the most common gynecological surgery performed. There are few studies evaluating hysterectomy as a risk factor for urinary incontinence. If hysterectomy is found to be a risk factor for developing urinary incontinence, women undergoing hysterectomy can be well informed prior to the procedure regarding the same. The objective of the present study was to study the prevalence of urinary incontinence in post-menopausal women and its relationship to hysterectomy. To evaluate the association of metabolic syndrome, to urinary incontinence.Methods: This study was a prospective cohort study done in Christian Medical College and Hospital, Vellore, Tamil Nadu between December 2016- December 2017. Postmenopausal women both with natural and surgical menopause, were enrolled into the study after an informed consent. The UDI-6 questionnaire was used to assess urinary incontinence. The categorical variables were presented using frequencies and percentages. The comparison of categorical variables was done using Fisher's exact test. The odds ratio and confidence interval were calculated for the prevalence. P value < 0.05 was considered to be statistically significant.Results: A total of 600 women were enrolled into the study with 300 women having attained natural menopause and 300 women with a surgical menopause. The prevalence of urinary incontinence among these post-menopausal women was 46.24%. The prevalence of urinary incontinence amongst the women with natural menopause was 47.3% and amongst the women with surgical menopause was 45% (p = 0.566). Women with metabolic syndrome suffered from urinary incontinence more than their counterparts without metabolic syndrome (55.8% vs. 36%, p <0.0001).Conclusions: The prevalence of urinary incontinence in the natural menopause and surgical menopause groups was similar, thus proving that hysterectomy is not a risk factor for developing urinary incontinence. However, metabolic syndrome was found to be associated with urinary incontinence.
ABSTRACT
Background: The objective of the present study was to observe the post void residual volume (PVRV) in women with pelvic organ prolapse (POP) pre and postoperatively and to correlate stage of prolapse with lower urinary tract symptoms and quality of life in women with pelvic organ prolapse.Methods: This is a prospective observational cohort study of 100 women with symptomatic pelvic organ prolapse of stage II or greater. Patients were admitted for Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in Gynaecology Department at Christian Medical College Hospital, Vellore, India over one year were recruited. This study was approved by the institutional review board and ethical committee of the hospital. Pre- and post-operative PVR were measured. The statistical analysis was done by using SPSS version 21 and P value < 0.05 was considered as statistically significant.Results: In this study 100 patients were recruited and 11% of women had pre-operative high post void residual volume of more than 100 ml. Stages of POP did not correlate with severity of LUTS and QOL. Pre-operative elevated PVR resolved post operatively in 91%, the P value <0.000 which was highly significant.Conclusions: 11% of women had preoperative high PVR. Stages of POP did not correlate with severity of lower urinary tract symptoms (LUTS) and quality of life(QOL). Pre-operative elevated PVR resolved post operatively in 91%, the P value < 0.000 which was highly significant. Majority of the patient with severe pelvic organ prolapse had elevated pre-op PVR which resolved post- operatively after surgical correction.