Occult urinary incontinence in women with severe prolapse evidenced by a minimally invasive test.

OBJECTIVES To evaluate the urodynamic changes when a severe cystocele is correct by a vaginal valve to identify occult urinary incontinence. METHOD Prospective study in 70 women at the Urogynecology and Vaginal Surgery Unit, in Clínica Las Condes. INCLUSION CRITERIA Symptomatic cystocele degree III or IV. EXCLUSION CRITERIA antecedent of incontinence and/o genital prolapse surgery; presence of urinary incontinence symptoms. In all patients the urethra retro-resistance pressure was measured by a non-multichannel urodynamic test with and without cystocele reduction by a vaginal Bresky valve. Additionally a cystometry was realized. RESULTS In all patients the URP was normal when the severe cystocele was not reduced. When the severe cystocele was reduced in 50 (71.4%) women the URP was altered. The cystometry identify asymptomatic overactive detrusor in 8 women. Occult urinary incontinence in the 50 women was: Type I in 1, type II in 27, type III in 1, type II+III in 21. CONCLUSION When a severe cystocele is reduced by a vaginal valve, urodynamic changes can be detected and women with occult urinary incontinence may be identified. These women may express symptoms of urinary incontinence when a prolapse surgery is realized.