title: [High dynamic risk cystoceles].
abstract: OBJECTIVE
  To assess the bladder compliance in a series of cystoceles referred for urodynamic study.
  
  
  METHODS
  Retrospective study of a series of patients with cystocele undergoing medical history, videurodynamic study, pelvic MRI and lower urinary tract, urological ultrasound and cystoscopy. We Excluded cases with neurogenic dysfunction and urinary infection. The terminology followed the criteria of the ICS, if not specified otherwise. The series includes 3333 cases of cystocele 616 of which are grade III cystocele. There were 3 cases with low bladder compliance; this is 0.0009% of total (1:1000) and 0.5% of grade III cystocele (1:200)
  
  
  RESULTS
  All cases of cystocele whith low compliance were associated with feeling of a bulk in the vagina and functional symptoms of lower urinary tract(LUTS). No urinary incontinence was related to cough. These patients also showed urodynamic alterations in the voiding phase, type hypo / acontractile detrusor and postvoid residual. The patients were subjected to various techniques of abdominal and transvaginal cystocele repair (with preventive anti-incontinence surgery), getting a vagina bulk disappearance, improvement of symptoms of lower urinary tract function, normalization of bladder compliance and detrusor contractility, with elimination of the postvoid residual.
  
  
  CONCLUSIONS
  Although they are not frequent, high-risk cystoceles should be discarded in high-grade cystocele that apart from low bladder accommodation, have a hipo/acontractile detrusor and postvoid residual. Surgical correction of cystocele not only reduces the bulk and LUTS, but normalizes urodynamic alterations.
authors.affiliation: Urology Department, Hospital Clinico de San Carlos, Universidad Complutense de Madrid, Spain. jsalinascasado@yahoo.es <jsalinascasado@yahoo.es>
authors.forename: Jesús
authors.initials: J
authors.lastname: Salinas Casado
authors.forename: Santiago
authors.initials: S
authors.lastname: Méndez Rubio
authors.forename: Miguel
authors.initials: M
authors.lastname: Virseda Chamorro
authors.forename: Humberto
authors.initials: H
authors.lastname: Pelaquim
authors.forename: Angel
authors.initials: A
authors.lastname: Silmi Moyano
mesh_terms: D000368:Aged; D052858:Cystocele / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014563:Urodynamics