--- title: Role of Urodynamics Before Prolapse Surgery description: A discussion of the role of urodynamics before prolapse surgery image: https://info.bhnco.com/hubfs/prolapse.jpg --- [![optional logo](https://info.bhnco.com/hs-fs/hubfs/BHN_logo-1.jpg?width=90&height=90&name=BHN_logo-1.jpg) Brighter Health Network Turn-key, On-site Medical Testing](http://www.bhnco.com/index.html) [Customer Sign in](http://www.bhnportal.com/) - [Home](https://www.bhnco.com/index.html) - [About us](https://www.bhnco.com/about_us.html) - Services - Urodynamic Services - [Urodynamic Testing Services](https://www.bhnco.com/Services/urodynamic-services.html) - [Urodynamics Training](https://www.bhnco.com/Services/urodynamics-training.html) - [Urodynamic Staffing Services](https://www.bhnco.com/Services/urology-obgyn-staff-services.html) - [Pediatric Urodynamic Services](https://www.bhnco.com/Services/pediatric-urodynamics-services.html) - Anorectal Manometry Services - [Anorectal Manometry Testing Services](https://www.bhnco.com/Services/anorectal-manometry-services.html) - [Anorectal Manometry Training](https://www.bhnco.com/Services/anorectal-manometry-training.html) - [Anorectal Manometry Staffing Services](https://www.bhnco.com/Services/gastroenterology-staff-services.html) - Other Services - [UroCuff Testing Servcies](https://www.bhnco.com/Services/urocuff-testing-services.html) - [Clinical Trial Support Services](https://www.bhnco.com/Services/clinical-trial-support-services.html) - [Medical Device Field Service/Support](https://www.bhnco.com/Services/medical-device-inservice-outsourcing-services.html) - [Careers](https://www.bhnco.com/BHN-Careers-Jobs.html) - [Blog](https://info.bhnco.com/blog) - Resources - General Resources - [Why outsourcing diagnostics is prudent?](https://www.bhnco.com/Resources/outsourcing-medical-diagnostics.html) - Urodynamics Resources - [What is a Urodynamics Test?](https://www.bhnco.com/Resources/what-is-a-urodynamics-test.html) - [Urodynamics - Useful Terms](https://www.bhnco.com/Resources/urodynamics-useful-terms.html) - [Urodynamics - Useful videos](https://www.bhnco.com/Resources/urodynamics-useful-videos.html) - [When should Urodynamics be performed?](https://www.bhnco.com/Resources/When-should-urodynamics-be-performed.html) - [Urodynamics Testing Best Practices](https://www.bhnco.com/Resources/urodynamics-testing-best-practices.html) - [Top 10 Urodynamics Mistakes](https://www.bhnco.com/Resources/top-ten-urodynamics-mistakes.html) - [Largest Urology Practices in U.S.](https://www.bhnco.com/Resources/largest-urology-practices-in-unitedstates.html) - [In-office Urodynamics Testing](https://www.bhnco.com/BHN_inoffice.htm) - Anorectal Manometry Resources - [What is Anorectal Manometry?](https://www.bhnco.com/Resources/What-is-anorectal-manometry.html) - [Anorectal Manometry - Useful Terms](https://www.bhnco.com/Resources/anorectal-manometry-useful-terms.html) - [Anorectal Manometry - Useful Videos](https://www.bhnco.com/Resources/anorectal-manometry-useful-videos.html) - [Why anorectal manometry?](https://www.bhnco.com/Resources/Why-anorectal-manometry.html) - [Contact](https://www.bhnco.com/contact.html) ![Collage_nurses_urodynamics_equipment.jpg](https://info.bhnco.com/hs-fs/hubfs/Collage_nurses_urodynamics_equipment.jpg?width=1920&name=Collage_nurses_urodynamics_equipment.jpg "Collage_nurses_urodynamics_equipment.jpg") ## BHN Healthcare Blog # Role of Urodynamics Before Prolapse Surgery Posted by [Clark Love](https://info.bhnco.com/blog/author/clark-love) on Jul 5, 2018 1:53:36 PM - [Tweet](https://twitter.com/share) **![prolapse](https://info.bhnco.com/hs-fs/hubfs/prolapse.jpg?width=470&name=prolapse.jpg)The topic of urodynamic studies (UDS) before** **[prolapse surgery](https://info.bhnco.com/blog/pelvic-organ-prolapse-and-urodynamics)** **is highly debated in urogynecology. There have been previous studies conducted on women who had prolapse and uncomplicated stress** **[urinary incontinence](https://info.bhnco.com/blog/what-is-incontinence-and-why-is-it-important)** **(SUI). Currently, there is no possibility of a universal consensus for UDS before prolapse surgery in women who have concomitant symptomatic SUI. The issue is that there is currently no evidence that the surgery outcome will be altered or not by being given a UDS. Thus, we must test further using randomized studies to advance and see if UDS can be useful before prolapse surgery.** ## Preoperative UDS Should Be Performed If a patient with a pelvic organ prolapse (POP) has either stages IIIa, IIc, or lp, she is more likely to have symptomatic vaginal bulging and asymptomatic for stress or urgency incontinence. This case is just one example of where preoperative USD should be performed before the prolapse surgery. It’s been found that POP and [lower urinary tract symptoms](https://info.bhnco.com/blog/urodynamics-guidelines-auas-latest-guidelines-on-urodynamics) (LUTS) usually coexist with each other. But, UDS involve objective assessments of any dysfunction in the urinary tract system. Some UDS could prevent and save people from POP. However, not many are willing to perform this option. Performing a preoperative UDS on patients before prolapse surgery could identify the patient's risk when it comes to the persistence of any other urgency where it is postoperative, incontinence, or voiding. By performing a UDS on a patient, you could help them assess the risks, pros, cons and ways to come up with a better treatment plan such as optimal preoperative counseling. ## Preoperative UDS Should Not Be Performed One of the [most recent studies](https://www.ncbi.nlm.nih.gov/pubmed/25315173)1 on this subject had 80 patients who suffered from POP and occult SUI. Each group was randomly assigned to prolapse surgery and concurrent TVT. After 24 months, they found that both had similar subjective and objective outcomes. Thus, it was concluded that the results showed a support policy that routine insertion of a sling in women with occult SUI at the time of prolapse repair is questionable and should be subject to shared decision-making between the clinician and patient. The reliability and clinical impact that UDS has had on prolapse patients remains one of the most unsure issues in the field of urogynecology. The only literature that is published focuses on UDS as a surgical treatment of SUI for women. The problem lies in uncomplicated and pure SUI are both a conflicting and heterogeneous trait. There is very little data when it comes to USD in the preoperative evaluation of women who are suffering from POP. So, the question is, can UDS change the choice of surgery? Or is it just a waste of resources and time? ## Urgency Incontinence & Voiding Dysfunction Another issue is that UDS tests can help predict symptoms of an overactive bladder, but only with a reduced cure rate. [Nguyen et al](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078259/)2 found that two-thirds of women were diagnosed with POP and symptomatic DO after prolapse repair. Nguyen et al. also found that two-thirds of women who have POP and concomitant [symptomatic DO](https://info.bhnco.com/blog/role-of-urodynamics-in-stress-incontinence-a-critical-appraisal) still have resolutions of DO even after the prolapse surgery. Thus, this means that it wasn’t a very effective method to use UDS before prolapse surgery. ## Discussion There have been signs that show UDS could better help identify urinary dysfunctions such as DO and SUI. However, these cases are rarely translated into a management plan or alter the type of surgical procedures being done. Plus, there is not enough data to demonstrate that UDS can help improve both subjective or objective outcomes of prolapse surgery. So, it is still recommended to go with surgical correction of prolapse because it can help improve the symptom of vaginal bulging,  can also help the symptoms of [OAB](http://www.bhnco.com/Resources/urodynamics-useful-terms.html), and even cure SUI. To say the very least, UDS should be a last resort for selected patients with genital prolapse and only if the UDS would be able to affect future treatment or management plans. ## Conclusion There is no proof, and it is not possible to reach a universal agreement when it comes to the role of UDS before prolapse surgeries. It’s been noted that UDS could potentially add valuable information for women who are suffering or undergoing POP surgery because it could help facilitate the sounding of patients. However, there is no proof to demonstrate that previous UDS alters the operation. This leads us to believe that there must be [more randomized studies](https://info.bhnco.com/blog/are-urodynamics-procedures-on-the-rise) for further testing to be done.   **References** 1. Serati M, Giarenis I, Meschia M, Cardozo L. Role of urodynamics before prolapse surgery. Int Urogynecol J. 2015;26(2):165-8. [Link](https://www.ncbi.nlm.nih.gov/pubmed/25315173) 2. Smith TM, DeLancey JOL, Fenner DE. Post-reduction stress urinary incontinence rates in posterior versus anterior pelvic organ prolapse: a secondary analysis. International urogynecology journal. 2013;24(8):1355-1360. doi:10.1007/s00192-012-2019-1. [Link](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078259/) Topics: [Urodynamics Testing](https://info.bhnco.com/blog/topic/urodynamics-testing), [urodynamics](https://info.bhnco.com/blog/topic/urodynamics), [pelvic organ prolapse](https://info.bhnco.com/blog/topic/pelvic-organ-prolapse) We hope our blog is helpful.  Please leave us your thoughts and feel free to share any posts of interest to you on your social media accounts using the social media links at the top. ### Subscribe to Email Updates ### Recent Posts ### Posts by Topic - [urodynamics (34)](https://info.bhnco.com/blog/topic/urodynamics) - [Urodynamics Testing (24)](https://info.bhnco.com/blog/topic/urodynamics-testing) - [Anorectal Manometry (9)](https://info.bhnco.com/blog/topic/anorectal-manometry) - [urodynamics equipment (8)](https://info.bhnco.com/blog/topic/urodynamics-equipment) - [General Urology Information (7)](https://info.bhnco.com/blog/topic/general-urology-information) - [Medical Practice Operations (7)](https://info.bhnco.com/blog/topic/medical-practice-operations) - [incontinence (7)](https://info.bhnco.com/blog/topic/incontinence) - [urodynamics service provider (7)](https://info.bhnco.com/blog/topic/urodynamics-service-provider) - [ObGyn Practices (6)](https://info.bhnco.com/blog/topic/obgyn-practices) - [male urodynamics (6)](https://info.bhnco.com/blog/topic/male-urodynamics) - [urodynamics staffing (6)](https://info.bhnco.com/blog/topic/urodynamics-staffing) - [urodynamics training (6)](https://info.bhnco.com/blog/topic/urodynamics-training) - [urodynamics interpretation (5)](https://info.bhnco.com/blog/topic/urodynamics-interpretation) - [Male Diagnostics (4)](https://info.bhnco.com/blog/topic/male-diagnostics) - [stress incontinence (4)](https://info.bhnco.com/blog/topic/stress-incontinence) - [urinariy incontinence (4)](https://info.bhnco.com/blog/topic/urinariy-incontinence) - [urodynamics profitability (4)](https://info.bhnco.com/blog/topic/urodynamics-profitability) - [urology (4)](https://info.bhnco.com/blog/topic/urology) - [Medical Device Field Service (3)](https://info.bhnco.com/blog/topic/medical-device-field-service) - [Pediatric Urodynamics (3)](https://info.bhnco.com/blog/topic/pediatric-urodynamics) - [Reimbursement (3)](https://info.bhnco.com/blog/topic/reimbursement) - [UroGynecology (3)](https://info.bhnco.com/blog/topic/urogynecology) - [Uroflowmetry (3)](https://info.bhnco.com/blog/topic/uroflowmetry) - [Urology Practice Trends (3)](https://info.bhnco.com/blog/topic/urology-practice-trends) - [outsourcing diagnostics (3)](https://info.bhnco.com/blog/topic/outsourcing-diagnostics) - [post-void residual (3)](https://info.bhnco.com/blog/topic/post-void-residual) - [urodynamic catheters (3)](https://info.bhnco.com/blog/topic/urodynamic-catheters) - [Anorectal Manometry Testing (2)](https://info.bhnco.com/blog/topic/anorectal-manometry-testing) - [BHN (2)](https://info.bhnco.com/blog/topic/bhn) - [Bladder Cancer (2)](https://info.bhnco.com/blog/topic/bladder-cancer) - [Cystometrogram (2)](https://info.bhnco.com/blog/topic/cystometrogram) - [Post-Operative Urodynamics (2)](https://info.bhnco.com/blog/topic/post-operative-urodynamics) - [Reimbursement Trends (2)](https://info.bhnco.com/blog/topic/reimbursement-trends) - [Reimbursments (2)](https://info.bhnco.com/blog/topic/reimbursments) - [Ultasound (2)](https://info.bhnco.com/blog/topic/ultasound) - [UroCuff (2)](https://info.bhnco.com/blog/topic/urocuff) - [Urodynamics Nurse (2)](https://info.bhnco.com/blog/topic/urodynamics-nurse) - [anorectal manometry procedure (2)](https://info.bhnco.com/blog/topic/anorectal-manometry-procedure) - [anorectal manometry test (2)](https://info.bhnco.com/blog/topic/anorectal-manometry-test) - [clinical operations (2)](https://info.bhnco.com/blog/topic/clinical-operations) - [interstitial cystitis (2)](https://info.bhnco.com/blog/topic/interstitial-cystitis) - [pelvic organ prolapse (2)](https://info.bhnco.com/blog/topic/pelvic-organ-prolapse) - [urodynamics billing (2)](https://info.bhnco.com/blog/topic/urodynamics-billing) - [urodynamics catheters (2)](https://info.bhnco.com/blog/topic/urodynamics-catheters) - [video urodynamics (2)](https://info.bhnco.com/blog/topic/video-urodynamics) - [American Urogynecologic Society (1)](https://info.bhnco.com/blog/topic/american-urogynecologic-society) - [Benign Prostatic Hyperplasia (1)](https://info.bhnco.com/blog/topic/benign-prostatic-hyperplasia) - [Brighter Health Network (1)](https://info.bhnco.com/blog/topic/brighter-health-network) - [Catheterization (1)](https://info.bhnco.com/blog/topic/catheterization) - [Colonoscopy (1)](https://info.bhnco.com/blog/topic/colonoscopy) - [Hirschsprung Disease (1)](https://info.bhnco.com/blog/topic/hirschsprung-disease) - [Incontinence Screening Questionnaires (1)](https://info.bhnco.com/blog/topic/incontinence-screening-questionnaires) - [Insider (1)](https://info.bhnco.com/blog/topic/insider) - [InterStim (1)](https://info.bhnco.com/blog/topic/interstim) - [International Urogynecological Association (1)](https://info.bhnco.com/blog/topic/international-urogynecological-association) - [Irritable Bowel Syndrome (1)](https://info.bhnco.com/blog/topic/irritable-bowel-syndrome) - [Medtronic NURO (1)](https://info.bhnco.com/blog/topic/medtronic-nuro) - [Nerve Blocks (1)](https://info.bhnco.com/blog/topic/nerve-blocks) - [Neurogenic Bladder (1)](https://info.bhnco.com/blog/topic/neurogenic-bladder) - [OAB Neuromodulation (1)](https://info.bhnco.com/blog/topic/oab-neuromodulation) - [Pelvic Floor Physical Therapy (1)](https://info.bhnco.com/blog/topic/pelvic-floor-physical-therapy) - [Rectoanal Inhibitory Reflexes (1)](https://info.bhnco.com/blog/topic/rectoanal-inhibitory-reflexes) - [Reimbursment Trends (1)](https://info.bhnco.com/blog/topic/reimbursment-trends) - [Spina Bifida (1)](https://info.bhnco.com/blog/topic/spina-bifida) - [Urgent PC (1)](https://info.bhnco.com/blog/topic/urgent-pc) - [Urodynamics And Artificial Intelligence (1)](https://info.bhnco.com/blog/topic/urodynamics-and-artificial-intelligence) - [Urodynamics Reimbursement Rates (1)](https://info.bhnco.com/blog/topic/urodynamics-reimbursement-rates) - [Urodynamics compliance (1)](https://info.bhnco.com/blog/topic/urodynamics-compliance) - [Uroflow (1)](https://info.bhnco.com/blog/topic/uroflow) - [Urology Jokes (1)](https://info.bhnco.com/blog/topic/urology-jokes) - [Urology Practice Staffing (1)](https://info.bhnco.com/blog/topic/urology-practice-staffing) - [ancillary services (1)](https://info.bhnco.com/blog/topic/ancillary-services) - [anorectal manometry treatment (1)](https://info.bhnco.com/blog/topic/anorectal-manometry-treatment) - [colonoscopies (1)](https://info.bhnco.com/blog/topic/colonoscopies) - [colpoplasty (1)](https://info.bhnco.com/blog/topic/colpoplasty) - [fecal incontinence (1)](https://info.bhnco.com/blog/topic/fecal-incontinence) - [finance (1)](https://info.bhnco.com/blog/topic/finance) - [hospital operations (1)](https://info.bhnco.com/blog/topic/hospital-operations) - [intraurethral (1)](https://info.bhnco.com/blog/topic/intraurethral) - [lidocaine (1)](https://info.bhnco.com/blog/topic/lidocaine) see all ### About us flexible and comprehensive urodynamics and anorectal manometry solutions delivered on-site. 1739 University Ave., #338, Oxford, MS 38655 888-508-3330 805-392-8111 [info@BHNCo.com](mailto:info@BHNCo.com) Copyright ©2022 Brighter Health Network, LLC all rights reserved | [Privacy Policy](http://www.bhnco.com/BHN-Privacy-Policy.html) Brighter Health Network ![](https://googleads.g.doubleclick.net/pagead/viewthroughconversion/959693890/?value=0&guid=ON&script=0)