Yonsei Med J.  2005 Jun;46(3):408-413. 10.3349/ymj.2005.46.3.408.

The Relationship between Maximal Urethral Closure Pressure and Functional Urethral Length in Anterior Vaginal Wall Prolapse Patients According to Stage and Age

• Bai SW
• Cho JM
• Kwon HS
• Park JH
• Shin JS
• Kim SK
• Park KH

• KMID: 1734077
• DOI: http://doi.org/10.3349/ymj.2005.46.3.408

Abstract

MUCP (Maximal urethral closure pressure) is known to be increased in patients with vaginal wall prolapse due to the mechanical obstruction of the urethra. However, urethral function following reduction has not yet been completely elucidated. Predicting postoperative urethral function may provide patients with important, additional information prior to surgery. Thus, this study was performed to evaluate the relationship between MUCP and functional urethral length (FUL) according to stage and age in anterior vaginal wall prolapse patients. 139 patients diagnosed with anterior vaginal wall prolapse at Yonsei University Medical College (YUMC) from March 1999 to May 2003 who had underwent urethral pressure profilometry following reduction were included in this study. The stage of pelvic organ prolapse (POP) was determined according to the dependent portion of the anterior vaginal wall (Aa, Ba). (By International Continence Society's POP Quantification system) Patients were divided into one of four age groups: patients in their 40s (n=13), 50s (n=53), 60s (n=54), and 70 and over (n=16). No difference in MUCP was found between the age groups. The FUL of patients in their 40s was shorter than that of patient's in their 50s and 60s. Patients were also divided into stages: stage II (n=35), stage III (n=76), and stage IV (n=25). No significant difference in MUCP was found according to stage and FUL. However, a significant difference was noted between stage III and IV as stage IV was longer. Anterior vaginal wall prolapse is known to affect urethral function due to prolapse itself, but according to our study, prolapse itself did not alter urethral function. This suggests that, regardless of age and stage, prolapse corrective surgery does not affect the urethral function.

Keyword

Anterior vaginal wall prolapse; maximal urethral closure pressure; functional urethral length

MeSH Terms

Adult
Age Factors
Aged
Female
Humans
Middle Aged
Postoperative Complications
Pressure
Urethra/*anatomy & histology/*physiology
Urinary Incontinence, Stress/etiology/physiopathology
Uterine Prolapse/pathology/*physiopathology/*surgery

Figure

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  Fig. 1 Parameters normally measured during urethral pressure profile studies (International Continence Society). a=maximum urethral pressure, b=maximum urethral closure pressure, c=bladder pressure, and d=functional profile length.

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