To explore the relationship between overactive bladder (OAB) symptoms and paravaginal defects (PVDs), and to identify the necessity of PVD repair by transvaginal mesh (TVM) for the treatment of OAB symptoms.
A retrospective clinical study of 30 women with advanced cystocele with limited apical and posterior vaginal wall prolapse was conducted to identify any changes in OAB symptoms following a single Perigee procedure. Prolapse was assessed using the pelvic organ prolapse quantification (POP-Q) system, and paravaginal defects were identified by sonography. Complete urodynamic examination was performed prior to and one year after operation. All patients completed the overactive bladder questionnaire pre- and postoperatively for a quantitative assessment of OAB symptoms.
All patients showed a significant improvement at points Aa and Ba in the POP-Q system. The results of the administered questionnaire revealed statistically significant improvement postoperatively. The difference of OAB symptoms between the group with PVDs and that with central defects was not statistically significant (p = 0.67). Moreover, no statistically significant improvement of OAB symptoms in the group with repaired PVDs was observed postoperatively (p = 0.42).
Statistical improvements of symptoms exist after Aa and Ba points recovery as evaluated by POP-Q system regardless of PVD existence identified by sonography. Repairing PVD did not show significantly improve the severity of OAB symptoms in objective urodynamic data or subjective questionnaire data. The superiority of TVM in PVD repair to manage OAB symptoms seems not manifest.
Journal of the Chinese Medical Association : JCMA. 2018 Feb 16 [Epub ahead of print]
Hung-Yen Chin, Huang-Hui Chen, Ching-Hui Chen, Chi-Hsin Chiang, Chin-Jung Wang
Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan, ROC., Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan, ROC., Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC., Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan, ROC., Department of Obstetrics and Gynecology, Division of Gynecologic Endoscopy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC. Electronic address: .