title: Incidence of hydronephrosis in severe uterovaginal or vault prolapse.
abstract: BACKGROUND
  We aimed to evaluate the local incidences of hydronephrosis and renal impairment in the presence of severe uterovaginal or vault prolapse, and determine whether treatment by surgery or ring pessary resulted in the resolution of hydronephrosis in these patients.
  
  
  METHODS
  This was a retrospective case study of 121 patients who presented with severe uterovaginal or vault prolapse. All patients who had fourth degree uterovaginal or vault prolapse, and underwent renal ultrasonography and renal function blood tests were included in the study. Follow-up imaging for hydronephrosis was performed to determine the outcome after patients received treatment.
  
  
  RESULTS
  The mean age of the study population was 66.1 years. The overall incidence of hydronephrosis was 20.6%. The incidence of hydronephrosis in patients with severe vault prolapse was 7.1%, while that in patients with severe uterovaginal prolapse was 22.4%. Of the 25 patients with hydronephrosis, 16 (64.0%) had complete resolution of hydronephrosis after treatment, 5 (20.0%) had residual but smaller degrees of hydronephrosis, and 4 (16.0%) were lost to follow-up. The incidence of renal impairment was 3.3%.
  
  
  CONCLUSIONS
  The local incidence of hydronephrosis in patients with severe uterovaginal or vault prolapse was 20.6% in our study. We established that 3.3% of women with severe uterovaginal or vault prolapse had mild renal impairment. Treatment by vaginal surgery for severe uterovaginal or vault prolapse appears to result in either complete resolution or improvement of hydronephrosis in the majority of patients.
authors.affiliation: Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore. wcube@hotmail.com
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Wee
authors.forename: Heng Fok
authors.initials: HF
authors.lastname: Wong
authors.forename: Lih Charn
authors.initials: LC
authors.lastname: Lee
authors.forename: How Chuan
authors.initials: HC
authors.lastname: Han
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D015994:Incidence; D007668:Kidney / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000150:complications; D007677:Kidney Function Tests; D008875:Middle Aged; D010570:Pessaries; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014596:Uterine Prolapse / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D014599:Uterus / Q000601:surgery; D014621:Vagina / Q000601:surgery