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Assessment of overactive bladder symptoms among women with successful pessary placement

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Abstract

Introduction and hypothesis

The causal association between pelvic organ prolapse (POP) and overactive bladder (OAB) symptoms is supported by several theories. The aim of this study is to assess any changes in OAB symptoms among women with POP and OAB after successful pessary placement.

Methods

During the study period, all women with symptomatic POP stage II or greater and OAB symptoms were offered the solution of either a ring or a Gellhorn pessary. All patients were asked to complete a 3-day micturition/incontinence diary. Objective evaluation endpoints at baseline and at 6 weeks included: change in the mean number of micturitions/24 h, change in the mean volume voided per micturition/24 h, and change in the number of urinary incontinence episodes. Subjective evaluation of the urgency, frequency, and nocturia symptoms was carried out using the score change of the questions 3, 5, and 2 of the International Consultation on Incontinence Questionnaire for Evaluating Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) respectively.

Results

Seventy-four women were included in the study. A statistically significant decrease (−28.3%; p < 0.001) of the mean number of micturitions/24 h with a significant increase (37%; p < 0.001) in the mean voided volume per micturition/24 h was observed. The total urine volume/24 h remained unchanged. The number of urinary incontinence episodes was significantly increased 6 weeks after pessary placement (p < 0.001). De novo stress urinary incontinence (SUI) was reported by 16.7% of the initially stress continent women.

Conclusions

Women with coexisting POP and OAB symptoms may experience a significant improvement in micturition frequency and in urgency and frequency symptoms after successful pessary fitting.

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Abbreviations

ES:

Effect size

ICIQ-FLUTS:

International Consultation on Incontinence Questionnaire for Evaluating Female Lower Urinary Tract Symptoms

IQR:

Interquartile range

OAB:

Overactive bladder

POP:

Pelvic organ prolapse

POP-Q:

Pelvic Organ Prolapse Quantification system

SD:

Standard deviation

SUI:

Stress urinary incontinence

UUI:

Urge urinary incontinence

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Authors and Affiliations

  1. First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece

    Dimitrios Zacharakis, Themos Grigoriadis, Eleni Pitsouni, Kostas Kypriotis, Nikistratos Vogiatzis & Stavros Athanasiou

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  1. Dimitrios Zacharakis
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  2. Themos Grigoriadis
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  3. Eleni Pitsouni
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  4. Kostas Kypriotis
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  5. Nikistratos Vogiatzis
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  6. Stavros Athanasiou
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Correspondence to Dimitrios Zacharakis.

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Zacharakis, D., Grigoriadis, T., Pitsouni, E. et al. Assessment of overactive bladder symptoms among women with successful pessary placement. Int Urogynecol J 29, 571–577 (2018). https://doi.org/10.1007/s00192-017-3461-x

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  • DOI: https://doi.org/10.1007/s00192-017-3461-x

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