title: [Modelled analysis of the effect of cystocele reduction with vaginal pack on miction in women with grade IV cystocele].
abstract: OBJECTIVE
  To evaluate the effect of reduction of a cystocele by vaginal pack on the voiding of women with grade IV cystocele.
  
  
  METHODS
  Two successive pressure-flow analyses were performed in a series of 21 patients: the first after insertion of a vaginal pack to reduce the cystocele, and the second after removal of the pack. The VBN method was applied to analyse uroflowmetries, allowing evaluation of two parameters for each uroflowmetry: one reflecting the urethra and the other reflecting the detrusor.
  
  
  RESULTS
  Only 14 patients were able to perform the 2 uroflowmetries in a single stream with a volume greater than 100 ml. The vaginal pack improved the urethral parameter in 10 patients, but had no effect in the other 4 patients; it did not alter detrusor function. The urethral parameter was improved in patients whose obstruction was relieved according to the urodynamic criterion.
  
  
  CONCLUSIONS
  Modelized analysis of pressure-flow analyses with and without a vaginal pack supports the conclusions of urodynamic tests concerning the preoperative status of patients with high grade cystocele by identifying those patients in whom the cystocele affects bladder emptying.
authors.affiliation: Université Pierre et Marie Curie, Paris 6, France. francoise.valentini@jrs.ap-hop-paris.fr
authors.forename: F
authors.initials: F
authors.lastname: Valentini
authors.forename: P E
authors.initials: PE
authors.lastname: Zimmern
authors.forename: G
authors.initials: G
authors.lastname: Besson
authors.forename: P
authors.initials: P
authors.lastname: Nelson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D012720:Severity of Illness Index; D001745:Urinary Bladder Diseases / Q000628:therapy*; D014554:Urination; D014563:Urodynamics; D014572:Urology / Q000295:instrumentation; D014621:Vagina