Ba. Rosenzweig et al., PREVALENCE OF ABNORMAL URODYNAMIC TEST-RESULTS IN CONTINENT WOMEN WITH SEVERE GENITOURINARY PROLAPSE, Obstetrics and gynecology, 79(4), 1992, pp. 539-542
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.