TVM ameliorates voiding dysfunctions
In addition to bowel and/or sexual disorders, POP patients also suffer from voiding dysfunctions28 that results in urine retention as a sequelae of inadequate bladder emptying29,30. Lasting urine retention is detrimental as it could result in frequency/recurrent urinary tract infections29 or damage to the upper urinary tract2.
Notably, urine retention in associated with a decreased compliance, deficits observed in pre-operative patients of this study, could be one of the causes underlying the urine incontinence as the accumulated volume could result in an abnormal pressure elevation that impels urine to be forced out. Particularly, as POP affects most commonly women elder than 70 years old4,5 and our previous publication has demonstrated the maximal urethral closure pressure deteriorates with age growth31; we thereby suggest a diminished bladder compliance in accompanied with urine retention in aged patients collectively prompts the pathological progression of urine incontinence in POP patients.
Remarkably, data in this study demonstrated that in patients displaying urine retention before operation, TVM effectively reduced the residual volume. Because the kinking- and/or compression-enhanced outlet resistance is recognized to underlie the development of voiding difficulties in POP patients32,33, this result suggests TVM ameliorates the voiding dysfunction possibly via reliving the kinking and/or compression of the urethra. Together with above findings, these results reveal TVM benefits to POP patients not only for it improves storage function but also for it mends voiding deficits by ameliorating urine retention that avoid the development of urine incontinence.