Pelvic organ prolapse (POP) is a prevalent illness that affects approximately 200,000 women in the United States each year. Lower urinary tract symptoms (LUTS) might continue or develop after surgical treatment. For a review, researchers advised on the most recent technologies for predicting, counseling on, and dealing with postoperative LUTS. The current literature on LUTS diagnosis and management in the context of prolapse surgery was reviewed, with an emphasis on the newest discoveries in this field. More severe stages of prolapse were linked to obstructive symptoms but not to other LUTS. A one-week ambulatory pessary trial was an excellent approach to predict postoperative outcomes—one research successfully predicted chronic urgency and frequency, as well as covert stress urine incontinence, in 20% of the study group. No preoperative overactive bladder (OAB) symptom was the strongest predictor of the lack of postoperative de novo OAB symptoms. Patients with urge incontinence benefited from sacral neuromodulation, botulinum toxin, and anticholinergic therapy. As first-line therapy, alpha antagonists or anticholinergics timed voiding, and pelvic physiotherapy effectively treated primary bladder outlet obstruction (BOO).
When contemplating POP surgery, it was critical to receive postoperative LUTS counseling. It was critical to have a complete awareness of the patient’s past in order to heal them successfully. Patients with considerable preoperative symptoms, a history of neurologic illness, pelvic floor dysfunction, bladder neck blockage, or advanced stages of anterior wall prolapse might be at increased risk of postoperative LUTS. UDS with or without reduction, as well as an ambulatory pessary trial, aided in prognosis. If patients are counseled prior to surgery, they are more likely to sustain a favorable treatment relationship for LUTS.
Reference:link.springer.com/article/10.1007/s11934-018-0825-9
