» Articles » PMID: 37010544

A Serious Consequence of Pelvic Organ Prolapse: Hydroureteronephrosis

Overview
Publisher Springer
Date 2023 Apr 3
PMID 37010544
Authors
Affiliations
Soon will be listed here.
Abstract

Introduction And Hypothesis: We aimed to determine the association between pelvic organ prolapse (POP) and hydroureteronephrosis (HUN), risk factors for developing HUN and resolution of HUN after surgery.

Methods: A retrospective study was conducted on 528 patients diagnosed with uterine prolapse.

Results: All patients with or without HUN were compared in terms of risk factors. The 528 patients were divided into five groups according to the POP-Q classification. A significant relationship was found between POP stage and HUN. The other risk factors for developing HUN were age, rural life, parity, vaginal delivery, smoking, body mass index and increased comorbidity. The prevalence of POP was 12.2% and the prevalence of HUN was 65.3%. All patients with HUN underwent surgery. After surgery, HUN resolved in 292 (84.6%) patients.

Conclusion: POP is a multifactorial herniation of pelvic organs out of the urogenital hiatus due to pelvic floor dysfunction. The main etiological factors in POP are older age, grand multiparity, vaginal delivery and obesity. The most important problem in patients with severe POP is HUN due to urethral kinking or urethral obstruction, which is a result of the cystocele squeezing the urethra under the pubic bone. In low-income countries, the main aim is to prevent the development of POP, which is the most common cause of HUN. It is important to increase the level of knowledge about contraception methods and to increase screening and training to reduce other risk factors. Women should be made aware of the importance of gynecological examination in the menopausal period.

References
1.
Swift S, Woodman P, OBoyle A, Kahn M, Valley M, Bland D . Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005; 192(3):795-806. DOI: 10.1016/j.ajog.2004.10.602. View

2.
Walker G, Gunasekera P . Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J. 2010; 22(2):127-35. DOI: 10.1007/s00192-010-1215-0. View

3.
Gemer O, Bergman M, Segal S . Prevalence of hydronephrosis in patients with genital prolapse. Eur J Obstet Gynecol Reprod Biol. 1999; 86(1):11-3. DOI: 10.1016/s0301-2115(99)00052-4. View

4.
Lukacz E, DuHamel E, Menefee S, Luber K . Elevated postvoid residual in women with pelvic floor disorders: prevalence and associated risk factors. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(4):397-400. DOI: 10.1007/s00192-006-0164-0. View

5.
Vecchio R, Marchese S, Leanza V, Leanza A, Intagliata E . Totally laparoscopic repair of an ileal and uterine iatrogenic perforation secondary to endometrial curettage. Int Surg. 2015; 100(2):244-8. PMC: 4337437. DOI: 10.9738/INTSURG-D-13-00267.1. View