Incontinencia de orina oculta en mujeres con prolapso genital severo evidenciada por una prueba mínimamente invasiva

Abstract

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. Arch. Esp. Urol. 2010; 63 (3): 188-194 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.