title: Pelvic organ prolapse and overactive bladder.
abstract: OBJECTIVE
  In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms depend on the prolapsed compartment and/or stage of the prolapse? *What is the possible pathophysiology of OAB in POP? *Do OAB symptoms and DO change after conservative or surgical treatment of POP?
  
  
  METHODS
  We searched on Medline and Embase for relevant studies. We only included studies in which actual data about OAB symptoms were available. All data for prolapse surgery were without the results of concomitant stress urinary incontinence (SUI) surgery.
  
  
  RESULTS
  Community- and hospital-based studies showed that the prevalence of OAB symptoms was greater in patients with POP than without POP. No evidence was found for a relationship between the compartment or stage of the prolapse and the presence of OAB symptoms. All treatments for POP (surgery, pessaries) resulted in an improvement in OAB symptoms. It is unclear what predicts whether OAB symptoms disappear or not. When there is concomitant DO and POP, following POP surgery DO disappear in a proportion of the patients. Bladder outlet obstruction is likely to be the most important mechanism by which POP induces OAB symptoms and DO signs. However, several other mechanisms might also play a role.
  
  
  CONCLUSIONS
  There are strong indications that there is a causal relationship between OAB and POP.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: T A
authors.initials: TA
authors.lastname: de Boer
authors.forename: S
authors.initials: S
authors.lastname: Salvatore
authors.forename: L
authors.initials: L
authors.lastname: Cardozo
authors.forename: C
authors.initials: C
authors.lastname: Chapple
authors.forename: C
authors.initials: C
authors.lastname: Kelleher
authors.forename: P
authors.initials: P
authors.lastname: van Kerrebroeck
authors.forename: M G
authors.initials: MG
authors.lastname: Kirby
authors.forename: H
authors.initials: H
authors.lastname: Koelbl
authors.forename: M
authors.initials: M
authors.lastname: Espuna-Pons
authors.forename: I
authors.initials: I
authors.lastname: Milsom
authors.forename: A
authors.initials: A
authors.lastname: Tubaro
authors.forename: A
authors.initials: A
authors.lastname: Wagg
authors.forename: M E
authors.initials: ME
authors.lastname: Vierhout
mesh_terms: D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D010570:Pessaries; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D001748:Urinary Bladder Neck Obstruction / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D053201:Urinary Bladder, Overactive / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D013519:Urogenital Surgical Procedures