Urethral profilometry in women with uterovaginal prolapse View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1995-02

AUTHORS

F. Zivkovic, G. Ralph, K. Tamussino, L. Michelitsch, J. Haas

ABSTRACT

The aim of the study was to investigate the continence mechanism in women with uterovaginal prolapse by analysing urethral pressure profiles. Twenty-four women (mean age 59.0±11.9 years, mean parity 3.1±1.6) with prolapse underwent urodynamic evaluation. Urethral pressure profiles were obtained with prolapse and after reduction of the prolapse with a swab stick in the posterior vaginal fornix. After reduction the maximum urethral closure pressure (MUCP) and pressure transmission ratios (PTR) in all four quartiles of the urethra decreased, the position of the MUCP was shifted proximally and the functional urethral length was increased. Thirteen women reported a history of continence and 11 reported incontinence. Ten of 13 women (77%) who reported continence with prolapse were incontinent with their prolapse reduced. In these women, MUCP and PTRs in the first three quartiles of the urethra decreased significantly upon prolapse reduction. In the patients who reported incontinence with prolapse, only the MUCP decreased significantly upon prolapse reduction. Comparisons between the historically continent and incontinent women showed a statistically significant difference only for PTRs in the second and third quartiles of the urethra before prolapse reduction. Because the position of maximum urethral closure pressure before reduction was located in the distal half of the urethra in all patients, we conclude that direct pressure of the prolapsed mass on the urethra (rather than kinking) is the mechanism masking incompetence of the urethral closure mechanism in women with uterovaginal prolapse. The 77% rate of latent incontinence in this series suggests that women with severe pelvic relaxation should undergo careful urogynecologic evaluation before an attempt at surgical correction. More... »

PAGES

10-13

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf01961841

DOI

http://dx.doi.org/10.1007/bf01961841

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032657497


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