Introduction
The urinary bladder collects and stores urine before its disposal. As a
hollow organ of high compliance, the pressure of the bladder is elevated
slightly in response to a considerable filling volume during the
storage1. Impaired bladder compliance is deleterious
because aberrantly elevated intra-vesical pressure could lead to upper
urinary tract damage2 and/or urinary
incontinence3.
The prevalence of pelvic organ prolapse (POP), i.e., pelvic organ(s)
protrudes beyond its anatomical confines, is increasing owing to the
continuously advancing age, as it affects most commonly women elder than
70 years old4,5. Notably, a retrospective
videourodynamic analysis demonstrates decreased bladder compliance is
positively correlated with the incidence of POP6.
Moreover, when compared with healthy volunteers, patients with stage
III-IV POP displays a lower bladder compliance at
urgency7, indicating POP patients is associated with a
diminished bladder compliance.
Trans-vaginal mesh (TVM), which aims to correct anatomical abnormalities
and thereby restore pelvic floor function8, is a
minimally invasive therapy for POP9. Though, in 2016,
USA Food and Drug Administration issued a notification concerning the
long-term safety of the TVM repair10, some TVM
kits11,12,13 are so far viable options for treating
POP because they offer a successful anatomical reconstruction and
satisfied objective outcomes14. Nevertheless, the
objective outcome of TVM on the storage function of the bladder,
particularly the compliance, has been scarcely investigated.
In the current study, the potential benefit of TVM on bladder storage of
POP patients was investigated. For this purpose, history of POP patients
with voiding difficulties were reviewed; and their data of urodynamic
investigations measured before and after the procedure were analyzed by
focusing on changes in bladder compliance and associated parameters.
Moreover, as a preclinical study has demonstrated pressure-volume
analysis (PVA) as a tool that graphically and conceptually assesses the
bladder compliance15; and a retrograde cohort analysis
has very recently established PVA in stress urinary incontinence
patients16, we established PVA of POP patients and
assayed the bladder compliance as the slope of the regression line of
the trajectory during the filling stage.