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Speciality Spotlight
Prolapse
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LJ Romanzi, et al (New York Hosp-Cornell Med Ctr)
The Effect of Genital Prolapse on Voiding,
J Urol 161: 581-586, 1999.
They found that women with grade 3 or 4 cystocele more commonly had urethral hypermobility and symptoms of voiding difficulty. Urodynamics showed bladder outlet obstruction in 4% with grade 1 or 2 cystocele and 58% with grade 3 or 4 cystocele.
Ring pessary reduction of prolapse during urodynamics is useful in determining symptomatic and occult conditions in women with severe prolapse.
Urinary incontinence may be masked by prolapsed bladder and kinked urethra and it is important to predict sphincter weakness, and “occult incontinence” before operations for pelvic relaxation.
