title: Urgency, detrusor overactivity and posterior vault prolapse in women who underwent pelvic organ prolapse repair.
abstract: BACKGROUND
  We investigated the relationship between posterior vault prolapse and overactive bladder (OAB) symptoms or detrusor overactivity (DO) and their changes after surgical repair.
  
  
  METHODS
  Forty-three patients with vault prolapse and prevalent posterior compartment prolapse underwent pelvic organ prolapse repair surgery: 28 received colposacropexy and 15 were treated by the vaginal approach. Subjective success was lack of prolapse-related symptoms or urgency. OAB symptoms, voiding symptoms and constipation were evaluated. Patient satisfaction was defined by a visual analog scale score (range 0-10). Objective anatomical success was defined as no vaginal prolapse of stage ≥2 at any vaginal site.
  
  
  RESULTS
  The median follow-up was 75 months (range 24-143). Preoperatively, 33/43 patients (76.74%) reported urgency. DO was found in 11/43 patients (25.6%), and 22/43 patients reported constipation. The anatomical outcome showed 2 persistent stage II rectoceles (6.9%). After surgery, OAB symptoms disappeared in 25/33 (75.88%) and persisted in 8 patients (24.2%); there was no de novo urgency. DO disappeared in 8/11 subjects (72.7%). Preoperative constipation was present in 17/33 patients with OAB symptoms (51.5%) and disappeared postoperatively in 13/17 patients (76.4%) (p < 0.013). De novo constipation appeared in 3 patients (associated with OAB in 2 patients).
  
  
  CONCLUSIONS
  Prevalent posterior compartment pelvic organ prolapse and OAB/DO were often associated. After surgery, OAB symptoms and DO were significantly reduced.
authors: Department of Urology and Andrology, University of Perugia, Perugia, Italy.
authors: Elisabetta
authors: E
authors: Costantini
authors: Massimo
authors: M
authors: Lazzeri
authors: Alessandro
authors: A
authors: Zucchi
authors: Luigi
authors: L
authors: Mearini
authors: Eugenia
authors: E
authors: Fragalà
authors: Michele
authors: M
authors: Del Zingaro
authors: Vittorio
authors: V
authors: Bini
authors: Massimo
authors: M
authors: Porena
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000209:etiology* / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000601:surgery; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D014596:Uterine Prolapse / Q000209:etiology* / Q000601:surgery; D014621:Vagina / Q000601:surgery