Urodynamic changes in urethrovesical function in relation to the degree of uterine prolapse

ABSTRACT

The anatomical closeness of internal female genital organs to the pelvic urinary system makes it clear that dislocation of the uterus and upper vagina, as happens with prolapse, may affect the bladder and/or urethra. The aim of the present study was to delineate the urodynamic changes in urethrovesical function in relation to different degrees of uterine prolapse. Thirty patients with different degrees of uterine prolapse were evaluated urodynamically cystometry and uroflowmetry revealed insignificant changes with different degrees of prolapse except for a significant reduction of the voiding and flow times secondary to significant acceleration of the flow rate in women with III degree uterine prolapse compared to those with I degree uterine prolapse. Profilometry revealed insignificant reduction of the maximum urethral pressure, maximum closure pressure and the functional urethral length in patients with Ill degree uterine prolapse although the incidence of urinary stress incontinence was insignificant higher in patients with I degree uterine prolapse. It is therefore enigmatic that women with the worst support defect, those with severe degrees of uterovaginal prolapse seldom have genuine stress incontinence