Short-term effects on voiding function after mesh-related surgical repair of advanced pelvic organ prolapse

Objective: This study aims to evaluate postoperative short-term voiding dysfunction and voiding function at 3 months after mesh-related advanced pelvic organ prolapse (POP) repair among Chinese women. Methods: In this prospective cohort study, 171 women with advanced anterior POP underwent mesh-related surgical repair using the new economical surgical method at Peking Union Medical College Hospital. Postoperative voiding dysfunction (PVD) was defined as a postvoid residual volume (PVR) of 100mL or more or greater than one third of the voided volume. Assessment of voiding function included preoperative and postoperative uroflowmetry, PVR examination, and the Chinese versions of the Urinary Distress Inventory-6 and the Incontinence Impact Questionnaire Short Form. T test, chi(2) test, Fisher's exact test, and multivariate logistic regression were used for data analyses. Results: Of the 171 women, 48 (28.1%) exhibited PVD, and 22 (12.9%) exhibited a residual urine volume of 200mL or more. Twenty-eight (58.3%) of 48 women reported symptom resolution within 3 days. Women with a residual urine volume of 200mL or more experienced greater difficulty recovering (P = 0.001). A higher Pelvic Organ Prolapse Quantification stage in the anterior compartment (odds ratio, 7.94; 95% CI, 2.1-30.3) and a lower preoperative average urine flow rate (odds ratio, 3.92; 95% CI, 1.90-8.06) were independent risk factors for PVD. The Urinary Distress Inventory-6 and the Incontinence Impact Questionnaire Short Form indicated significant improvement from baseline at 3 months after surgical operation (P = 0.026 and P = 0.043, respectively), whereas average flow rate and bladder capacity significantly decreased from baseline (P = 0.011 and P < 0.001, respectively). Conclusions: Women with a higher Pelvic Organ Prolapse Quantification stage in the anterior compartment and a lower preoperative average urine flow rate are prone to PVD, whereas a cutoff PVR value of 200mL might be appropriate for defining PVD to avoid potential overtreatment.