Aimjirakul Komkrit, Ng Jun Jiet, Saraluck Apisith, Wattanayingcharoenchai Rujira, Mangmeesri Peeranuch, Manonai Jittima
Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Int J Womens Health. 2023 Jul 13;15:1039-1046. doi: 10.2147/IJWH.S413670. eCollection 2023.
Overactive bladder (OAB) symptoms are common in women with pelvic organ prolapse (POP), but the explanation is unclear. It is also uncertain whether OAB symptoms improve or persist after POP reduction. This study aimed to determine the prevalence and risk factors for OAB symptoms in women with POP, and to compare the improvement of OAB symptoms among women in three treatment groups: pelvic floor exercise, pessary, and surgery.
This retrospective cohort study included patients who visited our urogynecology clinic from January 2016 to December 2020. The Pelvic Floor Bother Questionnaire was used to evaluate selected pelvic floor symptoms (OAB and POP). Demographic characteristics and clinical findings, including Pelvic Organ Prolapse Quantification System and number of prolapsed compartments, were analyzed. Univariate and multivariate analyses were conducted to identify risk factors for OAB symptoms in women with POP. Subgroup analyses were performed in 533 patients to evaluate the improvement of OAB symptoms following POP treatment.
A total of 754 patients were analyzed. The incidence of OAB symptoms was 70% (533/754) and two-thirds (65%) reported moderate to severe bother. The lowest points of the anterior wall (OR 0.60; 95% CI 0.41-0.87; p = 0.01), longer perineal body (OR 0.78; 95% CI 0.21-0.76; p = 0.02), and previous vaginal delivery (OR 2.10; 95% CI 1.14-3.89; p = 0.02) were identified as significant risk factors. In the subgroup analyses, improvement in OAB symptoms was observed in 36.6% (195/533) of women who underwent POP treatment. Compared with pelvic floor exercise, pessary (OR 1.40; 95% CI 0.94-2.07; p = 0.10) and surgery (OR 1.30; 95% CI 0.80-2.12; p = 0.28) had higher odd ratios but the effects were not significant.
The prevalence of OAB symptoms in women with POP was high at 70%. Improvement in OAB symptoms was observed in one-third of women who underwent POP treatment. However, there were no significant differences between the treatment methods.
膀胱过度活动症（OAB）症状在盆腔器官脱垂（POP）的女性中很常见，但原因尚不清楚。POP复位后OAB症状是改善还是持续也不确定。本研究旨在确定POP女性中OAB症状的患病率和危险因素，并比较盆底肌锻炼、子宫托和手术这三个治疗组女性OAB症状的改善情况。
这项回顾性队列研究纳入了2016年1月至2020年12月期间到我们的女性盆底疾病诊所就诊的患者。使用盆底困扰问卷来评估选定的盆底症状（OAB和POP）。分析了人口统计学特征和临床发现，包括盆腔器官脱垂量化系统和脱垂腔室数量。进行单因素和多因素分析以确定POP女性中OAB症状的危险因素。对533例患者进行亚组分析，以评估POP治疗后OAB症状的改善情况。
共分析了754例患者。OAB症状的发生率为70%（533/754），三分之二（65%）的患者报告有中度至重度困扰。前壁最低点（OR 0.60；95%CI 0.41-0.87；p = 0.01）、会阴体较长（OR 0.78；95%CI 0.21-0.76；p = 0.02）和既往阴道分娩（OR 2.10；95%CI 1.14-3.89；p = 0.02）被确定为显著危险因素。在亚组分析中，接受POP治疗的女性中有36.6%（195/533）的OAB症状得到改善。与盆底肌锻炼相比，子宫托（OR 1.40；95%CI 0.94-2.07；p = 0.10）和手术（OR 1.30；95%CI 0.80-2.12；p = 0.28）的比值比更高，但效果不显著。
POP女性中OAB症状的患病率高达70%。接受POP治疗的女性中有三分之一的OAB症状得到改善。然而，治疗方法之间没有显著差异。
