Urologic Survey (Functional Urology)

Re: Prevalence of Hydronephrosis in Women with Advanced Pelvic Organ Prolapse


  • Lokman Irkilata

J Urol Surg 2015;2(3):158-158


In pelvic organ prolapse (POP) patients, hydronephrosis may develop and obstructive uropathy may be encountered as a result. Though the development mechanism of hydronephrosis is not fully known, the most frequently blamed mechanism is voiding dysfunction and bladder outlet obstruction (BOO). This year, Dancz et al. included 180 female patients with POP in their study and determined the prevalence of hydronephrosis with POP and the clinical and urodynamic parameters relating to hydronephrosis. The study was designed as a prospective, observational cohort study researching hydronephrosis in women with advanced degrees of POP. Women with at least +1 points for C, Aa and Ba points on POP-Q investigation were assessed for hydronephrosis. The presence of diabetes mellitus was found to be related to hydronephrosis to a significant degree (8% to 21%, p=0.009). A greater degree of hydronephrosis was observed in those with high mean values of POP degree at Aa, Ba, C and D for anterior and apical POP (p<0.01), however, no such relationship was found for posterior POP. On multi-channel urodynamic tests, hydronephrosis patients had higher residual urine amounts, lower mean first leak volume and higher mean maximum cystometric capacity compared to patients without hydronephrosis. The prevalence of hydronephrosis among women with advanced POP was identified as 30.6%. The authors concluded that diabetes mellitus and the degree of anterior or apical POP were related to hydronephrosis. Urodynamically, increased post voiding residue, higher cystometric capacity and lower volume at first leak were related to hydronephrosis. This study contains important data revealing the relationship between POP and hydronephrosis.