The role of pelvic organs prolapse in the etiology of urinary incontinence in women

Mahtab Zargham, Farshid Alizadeh, Amir Moayednia, Saeed Haghdani, Kia Nouri-Mahdavi, Mahtab Zargham, Farshid Alizadeh, Amir Moayednia, Saeed Haghdani, Kia Nouri-Mahdavi

Abstract

Background: Urinary incontinence is relatively common in women and is usually associated with pelvic organs prolapse. Our aim was to determine the relationship between type and intensity of urinary incontinence and different grades and types of pelvic organ prolapse among women.

Materials and methods: One-hundred female patients with the chief complaint of incontinence, who were diagnosed with pelvic organ prolapse participated in this study. Intensity of prolapse, stress and urge incontinence were evaluated using POP-Q (Pelvic Organ Prolapse Questionnaire), SEAPI (Stress related, Emptying ability, Anatomy, Protection, Inhibition) and Freeman criteria, respectively.

Results: Patients' mean age was 51.95 ± 12.82 years. The most common type of incontinence was stress incontinence (53%) and the most common prolapse type was cystocele (76%). Cystocele and rectocele had a significant relationship with stress (P value = 0.012) and urge incontinence (P value = 0.035), respectively; however, no relationship was observed between different grades of cystocele, rectocele and enterocele with different types of urinary incontinence (P value > 0.05). In patients with urge and mixed incontinence, prolapse grade significantly increased with age, but no such relationship was found in patients with stress incontinence. The number of vaginal deliveries had a significant relationship only with cystocele and rectocele grade; however, the relationship between other variables such as intensity of different types of urinary incontinence and enterocele grade with the number of deliveries was not significant.

Conclusion: Pelvic organ prolapse had a significant relationship with urinary incontinence regardless of intensity and POP should be examined in all of these patients.

Keywords: Etiology; incontinence; pelvic organ prolapse.

Conflict of interest statement

Conflict of Interest: None declared

References

    1. DeLancey JO. Structural aspects of the extrinsic continence mechanism. Obstet Gynecol. 1988;72:296–301.
    1. Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol. 2001;185:1332–7.
    1. Gutman RE, Ford DE, Quiroz LH, Shippey SH, Handa VL. Is there a pelvic organ prolapse threshold that predicts pelvic floor symptoms? Am J Obstet Gynecol. 2008;199:683e1–7.
    1. Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, et al. Pelvic Organ Support Study (POSST): The distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192:795–806.
    1. Mouritsen L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic ogan prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:122.
    1. Brubaker L, Norton P. Current clinical nomenculature for description of pelvic organ prolapse. Journal ofPelvic Surgery. 1996;2:257–7.
    1. Stothers L. Reliability, validity, and gender differences in the quality of life index of the SEAPI-QMM incontinence classification system. Neurourol Urodyn. 2004;23:223–8.
    1. Cardozo L, Coyne KS, Versi E. Validation of the urgency perception scale. BJU Int. 2005;95:591–6.
    1. Buckley BS, Lapitan MC. Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Prevalence of urinary incontinence in men, women, and children–current evidence: Findings of the Fourth International Consultation on Incontinence. Urology. 2010;76:265–70.
    1. Milson I, Altman D, Lapitan A. Epidemiology of urinary and faecal Incontinence and pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Plymouth, UK: Health Publication Ltd; 2009. pp. 35–112.
    1. DuBeau CE, Kuchel GA, Johnson T. Abrams P, Cardozo L, Khoury S, Wein A. Incontinence. 4th ed. Plymouth, UK: Health Publication Ltd; 2009. Incontinence in the Frail Elderly; pp. 961–1024.
    1. Ghanbari Z, Rostaminia Gh, Kajbafzadeh AB, Pirzadeh L, Haghollahi F, Naghizadeh MM, et al. Urodynamic evaluation of pelvic organ prolapse: Women with and without urinary incontinence. Tehran University Medical Journal. 2009;67:643.
    1. Bai SW, Kang SH, Kim SK, Kim JY, Park KH. The effect of pelvic organ prolapse on lower urinary tract function. Yonesi Med J. 2003;44:94–8.
    1. Bai SW, Jeon MJ, Kim JY, Chung KA, Kim SK, Park KH. Relationship between stress urinary incontinence and pelvic organ prolapsed. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13:256–60.
    1. Buchsbaum GM. urinary incontinence and pelvic organ prolapsed. Minerva Urol Nefrol. 2006;58:311–9.
    1. Delancy JO. Structural support of the urethra and its relation to stress urinary incontinence: The hammock hypothesis. Am J Obstet Gynecol. 1994;170:1713–20. discussion 1720-3.
    1. Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300:1311–6.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever