Comparison of Preoperative and Postoperative Post Void Residual Urine Volume In Urogenital Prolapse

Abstract

Background and objectives ABSTRACT The genital prolapse causes bladder dysfunction because of the anatomical closeness of female genital organs to the pelvic urinary system. PVR is a key marker for the evaluation of the efficacy of bladder emptying particularly in women with pelvic organ prolapse and lower urinary tract dysfunction. Objectives of the present study were to compare pre and post operative post void residual urine volume and to know the relation of PVR to urinary symptoms and prolapse. Methods The present study was conducted in Department of Obstetrics and Gynaecology, KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum over a period of one year during October 2008 to September 2009 on 65 patients admitted with urogenital prolapse. Detailed history, general physical examination was done as per predesigned and pretested proforma. Grading for prolapse was done by POP-Q, Baden walker halfway. PVR was measured before and after operation. Results Patients were aged between 25 to 72 years. 45 patients were postmenopausal. Age has shown significant relation with the raised PVR > 50 ml ( p=0.007) . Out of 65 cases, 11 had second, 48 had third degree and 6 had procedentia according to Baden Walker system. Urge and stress incontinence were complained by 43% and 26% of patients respectively and increased VIII frequency and nocturia was complained by 68% and 65% of patients. Storage symptoms were not significantly associated with degree of prolapse or raised PVR. straining to void, incomplete emptying and has to reduce to void were present in 42, 46 and 47 patients respectively and showed significant association with degree of prolapse. Except incomplete emptying other two were associated with raised PVR. Conclusions and interpretation Raised PVR has shown significant association with increasing degree of prolapse as well as obstructive urinary symptoms like straining to void, incomplete emptying and has to reduce prolapse to void. Vaginal hysterectomy with anterior colporrhaphy was effective procedure in reducing elevated PVR in prolapse patients.