Register for Pessary provides retention relief from elevated postvoid residual volumes
Urinary IncontinenceAugust 9, 2004
2004 AUG 9 - (NewsRx.com & NewsRx.net) -- Preoperative pessary reduction of anterior vaginal wall prolapse provides retention relief for most women with elevated postvoid residual (PVR) volumes, according to a study by gynecologists with the Montefiore Medical Center in New York City.
They also reported that pessary testing is sensitive, specific, and has positive predictive value for postoperative cure of urinary retention.
"The records of all women with symptomatic anterior vaginal wall and urinary retention (PVRgreater than or equal to100 cc) who underwent evaluation and surgical repair of the anterior vaginal wall at our institution between 1996 and 1999 were retrospectively reviewed. All patients underwent a detailed urogynecologic and urodynamic evaluation and had a pessary trial prior to surgery," said G. Lazarou and colleagues.
"Cure of urinary retention was defined as PVR <100 cc at 3 months postoperatively. Sensitivity, specificity, [and] positive and negative predictive values for pessary reduction testing were calculated," they continued.
Of the 24 patients included in the researchers' evaluation, 2 (8%) had stage 2 anterior vaginal wall prolapse, 11 (46%) had stage 3, and the other 11 had stage 4.
Lazarou and team reported that "[p]reoperatively, the use of pessary was associated with relief of urinary retention in 75% patients. In predicting postoperative cure of urinary retention, pessary testing had a sensitivity of 89%, specificity of 80%, positive predictive value of 94%, and negative predictive value of 67%."
They calculated a 79% cure rate for urinary retention in this group, with 19 of the 24 women having PVR <100 cc postoperatively.
"In women with symptomatic anterior vaginal wall prolapse and urinary retention, use of a pessary is associated with relief of retention in the majority of patients. Furthermore, pessary reduction testing has good sensitivity, specificity, and positive predictive value for postoperative voiding function," concluded the gynecologists.
Lazarou and coauthors published their study in the International Urogynecology Journal (Pessary reduction and postoperative cure of retention in women with anterior vaginal wall prolapse. Int Urogynecol J, 2004;15(3):175-178).
For more information, contact G. Lazarou, Jack D. Weiler Hospital, Albert Einstein College of Medicine, Montefiore Medical Center, Department of Obstetrics and Gynecology, 3332 Rochambeau Ave., Bronx, NY 10467 USA.
Publisher contact information for the International Urogynecology Journal is: Springer-Verlag London Ltd., Sweetapple House Catteshall Road, Godalming GU7 3DJ, Surrey, England.
The information in this article comes under the major subject areas of Urogynecology, Urinary Incontinence, Medical Devices, and Women's Health. This article was prepared by OBGYN & Reproduction Week editors from staff and other reports. Copyright 2004, OBGYN & Reproduction Week via NewsRx.com & NewsRx.net.
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