Munno Gaetano Maria, La Verde Marco, Lettieri Davide, Nicoletti Roberta, Nunziata Maria, Fasulo Diego Domenico, Vastarella Maria Giovanna, Pennacchio Marika, Scalzone Gaetano, Pieretti Gorizio, Fortunato Nicola, De Simone Fulvio, Riemma Gaetano, Torella Marco
Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Healthcare (Basel). 2023 May 22;11(10):1513. doi: 10.3390/healthcare11101513.
(1) Background: This narrative review aimed to analyze the epidemiological, clinical, surgical, prognostic, and instrumental aspects of the link between pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), collecting the most recent evidence from the scientific literature. (2) Methods: We matched the terms "pelvic organ prolapse" (POP) and "lower urinary tract symptoms" (LUTS) on the following databases: Pubmed, Embase, Scopus, Google scholar, and Cochrane. We excluded case reports, systematic reviews, articles published in a language other than English, and studies focusing only on a surgical technique. (3) Results: There is a link between POP and LUTS. Bladder outlet obstruction (BOO) would increase variation in bladder structure and function, which could lead to an overactive bladder (OAB). There is no connection between the POP stage and LUTS. Prolapse surgery could modify the symptoms of OAB with improvement or healing. Post-surgical predictive factors of non-improvement of OAB or de novo onset include high BMI, neurological pathologies, age > 65 years, and the severity of symptoms; predictors of emptying disorders are neurological pathologies, BOO, perineal dysfunctions, severity of pre-surgery symptoms, and severe anterior prolapse. Urodynamics should be performed on a specific subset of patients (i.e., stress urinary incontinence, correct surgery planning), (4) Conclusions: Correction of prolapse is the primary treatment for detrusor underactivity and for patients with both POP and OAB.
(1) 背景：本叙述性综述旨在分析盆腔器官脱垂（POP）与下尿路症状（LUTS）之间联系的流行病学、临床、手术、预后及器械方面，收集科学文献中的最新证据。(2) 方法：我们在以下数据库中匹配了“盆腔器官脱垂”（POP）和“下尿路症状”（LUTS）：PubMed、Embase、Scopus、谷歌学术和Cochrane。我们排除了病例报告、系统评价、非英文发表的文章以及仅关注一种手术技术的研究。(3) 结果：POP与LUTS之间存在联系。膀胱出口梗阻（BOO）会增加膀胱结构和功能的变化，这可能导致膀胱过度活动症（OAB）。POP分期与LUTS之间没有关联。脱垂手术可改善或治愈OAB症状。OAB无改善或新发的术后预测因素包括高体重指数、神经病理学、年龄>65岁以及症状严重程度；排空障碍的预测因素为神经病理学、BOO、会阴功能障碍、术前症状严重程度以及严重的前壁脱垂。尿动力学检查应在特定患者亚组中进行（即压力性尿失禁、正确的手术规划）。(4) 结论：脱垂矫正术是治疗逼尿肌功能减退以及同时患有POP和OAB患者的主要治疗方法。
