Jyothi Prabhakar Rao
BACKGROUND Pelvic organ prolapse is a common gynaecological problem among parous women. Many of them suffer from lower urinary complaints. They undergo a surgery before evaluation of the lower urinary tract complaints and sometimes end up with new complaints. Hence, it is important to evaluate pelvic organ prolapse women with basic urodynamic studies before undertaking corrective prolapse surgery. The aim of this study is to evaluate hundred cases of pelvic organ prolapse with basic urodynamics studies like cystourethroscopy, uroflow studies and post void residual urine to detect lower urinary symptoms. Many women with pelvic organ prolapse do not complain of urinary symptoms. Post-surgery, they manifest with new urinary complaints. Hence, it is important to evaluate prolapse cases with basic urodynamics before corrective surgery. MATERIALS AND METHODS A total of 100 women with pelvic organ prolapse were staged using POP-Q (Pelvic Organ Prolapse Quantification) method and evaluated with uroflow study, post void residual urine and cystourethroscope. RESULTS In our study of hundred cases of prolapse, commonest type was stage 4 (61%). The least common type was class 1 (2%). Among these, the commonest urinary complaint was frequency (35%) followed by poor stream (22%). Least common complaint was of urge incontinence and mixed incontinence (1%) and (3%) respectively. Reduced AFR was found in 55% of women of which majority were stage 4. Also, 10% had normal AFR of which 2% were stage 4. QMAX was <15 ml in 44% of women and normal (36 ml) in 29%. Eighty percent of patients had increased post void residual urine with 23% having between 50-150 ml and 57% having less than 150 ml. Normal post void residual urine was found in 20%. Normal cystourethroscopy findings were found in 95% of women and only 5% had abnormal findings. CONCLUSION Uroflow studies and postvoid residual urine were helpful but cystourethroscopy was not. These tests can be used as basic screening tests for women posted for prolapse corrective surgery.
