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.