Upper urinary tract damage in women with bladder outlet obstruction and advanced pelvic organ prolapse

Zaira G. Brizuela-Galindo, Departamento de Ginecología y Obstetricia, Unidad Médica de Alta Especialidad (UMAE), Hospital de Ginecoobstetricia, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México
Ena M. Lomelí-Muñoz-Márquez, Departamento de Urología Ginecológica, UMAE, Hospital de Ginecoobstetricia, No. 4, Mexico City, Mexico
Rafael H. Sandoval-Gómez, Departamento de Urodinamia y Urología Ginecológica, UMAE, Hospital de Ginecoobstetricia, Número 4, IMSS, Mexico City, Mexico
Carlos J. Molina-Pérez, División de Investigación en Salud, UMAE, Hospital de Ginecoobstetricia, Número 4, IMSS, Mexico City, Mexico
Erick Sierra-Díaz, División de Epidemiología, UMAE Hospital de Especialidades Centro Médico Nacional de Occidente, Guadalajara, Jalisco, Mexico
Julissa Lizaola-Navarro, Unidad de Vigilancia Epidemiológica, Hospital General Regional No. 4, IMSS, Guadalajara, Jalisco, México
Aurora A. Martínez-Manzanarez, División de Epidemiología, UMAE Hospital de Especialidades, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, México

Introduction: Pelvic organ prolapse is a common condition in postmenopausal women. Upper urinary tract damage is an important complication of advanced genital prolapse. Objective: To determine the relationship between detrusor pressure and upper urinary tract damage. Material and methods: A cross-sectional study was performed in women with pelvic organ prolapse. Clinical and urodynamic variables were measured. Measures of central tendency, and mean difference were used to describe the population issues. Results: A total of 56 patients were studied, with grade Ill organ prolapse being the most frequent (73.2%). The difference in detrusor pressure between patients with and without damage to the upper urinary tract was 1.83 cmH2O (53.58 versus 51.75 p > 0.05). The time of evolution of genital prolapse presented in the total population was 33 months. However, the average time of evolution in patients with damage to the upper urinary tract was 40 months, similar to that of the general population and the population without evident damage (p > 0.05). Conclusion: Detrusor pressure value is similar between women with and without upper urinary tract damage. Renal ultrasound may be useful in all women with advanced pelvic organ prolapse regardless of detrusor pressure in order to detect upper urinary tract damage.

Keywords: Pelvic organ prolapse. Urodynamics. Detrusor pressure. Renal ultrasound. Upper urinary tract damage.