From the Georgetown University/MedStar Washington Hospital Center, Washington, DC.
Christiana Care Health System, Newark, DE.
Female Pelvic Med Reconstr Surg. 2020 Mar;26(3):212-218. doi: 10.1097/SPV.0000000000000683.
The aim of this study was to report the prevalence of hydronephrosis associated with pelvic organ prolapse (POP).
We conducted a MEDLINE and PubMed search from 1996 to October 2016 using PRISMA guidelines. Eight studies met criteria for inclusion, including 3 prospective and 5 retrospective studies.
The prevalence of hydronephrosis ranged from 3.5% to 30.6% in studies that included multiple stages of prolapse. Hydronephrosis correlated with prolapse severity in multiple studies, but serum creatinine did not consistently predict hydronephrosis. Two studies reported a significantly higher prevalence of hydronephrosis in patients with uterovaginal prolapse compared with vaginal vault prolapse. Complete resolution of hydronephrosis was described in 56% to 83% of patients after undergoing surgical treatment for advanced prolapse.
Hydronephrosis among patients with POP is not rare, and we suggest consideration of upper tract evaluation in patients presenting with POP, particularly in those with advanced uterovaginal prolapse electing to proceed with expectant or conservative management.
本研究旨在报告与盆腔器官脱垂（POP）相关的肾积水的患病率。
我们按照 PRISMA 指南，对 1996 年至 2016 年 10 月期间的 MEDLINE 和 PubMed 进行了检索。共有 8 项研究符合纳入标准，包括 3 项前瞻性研究和 5 项回顾性研究。
在纳入多个脱垂阶段的研究中，肾积水的患病率范围为 3.5%至 30.6%。多项研究表明肾积水与脱垂严重程度相关，但血清肌酐并不能始终预测肾积水。有两项研究报告称，与阴道穹隆脱垂相比，子宫阴道脱垂患者的肾积水患病率显著更高。对晚期脱垂患者行手术治疗后，56%至 83%的患者肾积水完全缓解。
POP 患者中肾积水并不少见，我们建议对出现 POP 的患者，特别是选择期待或保守治疗的晚期子宫阴道脱垂患者，考虑进行上尿路评估。
