PREVALENCE OF ABNORMAL URODYNAMIC TEST-RESULTS IN CONTINENT WOMEN WITH SEVERE GENITOURINARY PROLAPSE

Twenty-two clinically continent women with severe genitourinary prolap se were evaluated urodynamically to determine the prevalence of urodyn amic abnormalities that could lead to potential urinary incontinence. Urodynamic testing found an occult incontinence disorder in 13 women ( 59%), of whom four had urine loss during cough pressure profiles after pessary placement, four had uninhibited detrusor contractions during retrograde medium-fill water cystometry, and five had both stress urin ary incontinence and an unstable bladder. Therefore, nine of the 22 pa tients (41%) had uninhibited detrusor contractions during urodynamic t esting. However, uroflowmetry did not reveal voiding dysfunction in th is group, although peak flow rates appeared to be lower in the subgrou p of women manifesting uninhibited detrusor contractions. Associated s ymptoms of frequency, nocturia, and urgency occurred in 41% of the wom en in this study; four of nine (44%) who had normal urodynamic test re sults, five of 13 (38%) who had abnormal test results, and five of nin e (56%) who had an unstable bladder. Therefore, associated symptoms co uld not be used to determine which women would have abnormal urodynami c test results. These preliminary results suggest that women with geni tourinary prolapse may be at risk for an occult incontinence disorder that is masked by the prolapse and that could manifest after correctiv e surgery for prolapse. Urodynamic testing is suggested for women with genitourinary prolapse who present with or without symptoms of incont inence, so that more data can be obtained to determine the importance of abnormal test results.