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Novel insight into the correlation between hernia orifice of cystocele and lower urinary tract function: a pilot study

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Title: Novel insight into the correlation between hernia orifice of cystocele and lower urinary tract function: a pilot study
Authors: Kitta, Takeya Browse this author
Abe, Hirokazu Browse this author
Huang Ting-wen Browse this author
Fujikawa, Masahiro Browse this author
Nakazono, Minoru Browse this author
Sasa, Taiki Browse this author
Doi, Yukiko Browse this author
Toki, Sari Browse this author
Okada, Daigo Browse this author
Ochi, Atsuhiko Browse this author
Suzuki, Koichiro Browse this author
Kitagawa, Yasuhide Browse this author
Shinohara, Nobuo Browse this author →KAKEN DB
Keywords: Pelvic organ prolapse
Voiding dysfunction
Anterior wall prolapse
Quality of life
Issue Date: 13-May-2022
Publisher: BioMed Central
Journal Title: BMC Women's Health
Volume: 22
Issue: 1
Start Page: 164
Publisher DOI: 10.1186/s12905-022-01747-5
Abstract: Background It has been hypothesized that women with significant pelvic organ prolapse (POP), particularly of the anterior vaginal wall, may have voiding dysfunction (VD). Although the VD mechanism due to cystocele is not fully understood, different vaginal compartments have rarely been closely examined. This study attempted to further elucidate the correlation between POP and VD through a new subgroup classification using cystoscopy. Methods This study reviewed clinical records of 49 women who underwent cystocele repair. All patients were scheduled for laparoscopic sacrocolpopexy, preoperatively underwent uroflowmetry and postvoid residual urine volume (PVR) measurement, and completed pelvic floor function questionnaires. Bladder examination by cystoscopy was additionally performed using the lithotomy position with the Valsalva maneuver. Results Subjects were divided into four groups according to hernia orifice presence determined by cystoscopy, which included the trigone type, posterior wall type, trigone and urethra type, and trigone and posterior wall type. The posterior wall type had statistically higher PVR values versus the trigone and posterior wall type (P = 0.013). The posterior wall type had statistically lower values for average urine flow rate versus the urethra and trigone type (P = 0.020). There were no significant differences noted in the pelvic floor function questionnaires among the four groups. Conclusions A new bladder defect classification based upon hernia orifice location was associated with lower urinary tract function. Posterior wall hernia presence caused significant voiding function deterioration. This new subgroup classification, which can more clearly identify and indicate bladder function, is also comparable among patients.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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