A prospective observational study of lower urinary tract symptoms before and after surgical removal of a large pelvic mass.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to assess the impact of the surgical removal of a large pelvic mass on preexisting lower urinary tract symptoms (LUTS) and function.

METHODS

This was a prospective study of planned surgical management of women with a large pelvic mass (uterine or ovarian mass ≥ 7 cm on pelvic ultrasound) who also reported bothersome LUTS (urinary frequency, urgency, incontinence and/or voiding dysfunction). Assessment included structured history and examination, completion of the short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), a 3-day bladder diary and multi-channel urodynamics (UDS) at baseline and 3 months postoperatively. The primary outcome was a reduction in the total mean scores of the UDI-6 and IIQ-7. Secondary outcomes were a change in bladder diary and UDS parameters. Univariate analysis and paired t test were used in the statistical analysis.

RESULTS

Twenty-nine women underwent surgical management of a pelvic mass. The most common preoperative urinary symptom was urinary urgency. Two women had overt urinary retention that resolved completely postoperatively. All women completed pre- and postoperative UDI-6 and IIQ-7. The UDI-6 and IIQ-7 demonstrated a highly significant reduction in the mean total scores of 66%, signifying symptom and quality of life improvement. Bladder diary parameters showed significant reductions in daytime urinary frequency and stress incontinence episodes. Maximum and average voided volumes increased by a mean of 60 ml. Only 14 women underwent postoperative UDS.

CONCLUSIONS

This study provides evidence that the majority of LUTS present preoperatively improve significantly or resolve completely following removal of a ≥ 7-cm pelvic mass.