Occult urinary incontinence in women with severe prolapse evidenced by a minimally invasive test.

OBJECTIVES

To evaluate the urodynamic changes when a severe cystocele is correct by a vaginal valve to identify occult urinary incontinence.

METHOD: Prospective study in 70 women at the Urogynecology and Vaginal Surgery Unit, in Clínica Las Condes.

INCLUSION CRITERIA: Symptomatic cystocele degree III or IV.

EXCLUSION CRITERIA: antecedent of incontinence and/o genital prolapse surgery; presence of urinary incontinence symptoms. In all patients the urethra retro-resistance pressure was measured by a non-multichannel urodynamic test with and without cystocele reduction by a vaginal Bresky valve. Additionally a cystometry was realized.

RESULTS

In all patients the URP was normal when the severe cystocele was not reduced. When the severe cystocele was reduced in 50 (71.4%) women the URP was altered. The cystometry identify asymptomatic overactive detrusor in 8 women. Occult urinary incontinence in the 50 women was: Type I in 1, type II in 27, type III in 1, type II+III in 21.

CONCLUSION

When a severe cystocele is reduced by a vaginal valve, urodynamic changes can be detected and women with occult urinary incontinence may be identified. These women may express symptoms of urinary incontinence when a prolapse surgery is realized.