Correlation of anterior vaginal wall prolapse and lower urinary tract symptoms

Background: The mechanism of lower urinary tract dysfunction due to anterior vaginal wall prolapse has not been fully understood. There have yet to be any definitive studies in Nepal. The aim of our study was to determine the correlation between the anterior vaginal wall prolapse and presence and severity of lower urinary tract symptoms. Methods: A cross-sectional observational study was conducted in the department of obstetrics and gynecology at Paropakar Maternity and Women’s Hospital. Eighty women aged ≥18 years with anterior vaginal wall prolapse were enrolled. Prolapse was staged (1-4) using the pelvic organ prolapse quantification (POP-Q) system and LUTS were assessed using international consultation on incontinence questionnaire-female lower urinary tract symptoms (ICIQ-FLUTS) long form questionnaire and categorized as storage, voiding, or stress urinary incontinence (SUI) symptoms. Association was calculated using Chi-Square Test and Fisher Exact Test and Spearman’s rank correlation. Results: Among the 80 patients with anterior vaginal prolapse, 15 (18.8%) were POP-Q stage 1, 30 (37.5%) were POPQ stage 2, 24 (30%) were POP-Q stage 3 and 11 (13.8%) were POP-Q stage 4. 61 (76.3%) women had storage symptoms, SUI in 35 (43.8%) and voiding symptoms in 25 (31.3%) women. Stage I anterior vaginal wall prolapse was significantly associated with SUI (p=0.04). Menopausal status of women was also found to be significantly associated with the storage symptoms (p=0.032). Conclusions: Our study demonstrated that stage I anterior vaginal wall prolapse was significantly associated with stress urinary incontinence (SUI), Also, menopausal status was found to be independently associated with the storage symptoms.