Contacts: Nechiporenko Aleksandr Nikolaevich, nechiporenko_al@mail.ru

Introduction: Uterine or vaginal prolapse (III-IV degree genital prolapse (GP)) in most cases is associated with dysfunction of the urinary tract. However, the publications which address the influence of GP with cystocele on condition of upper urinary tract and renal function are few.

Aim of this study was to analyze the results of examination of women with GP and manifest cystocele in order to assess the anatomical condition of upper urinary tract and renal function before and after surgery to restore urinary bladder position with vaginal extraperitoneal colpopexy using synthetic graft.

Materials and methods: we assessed the condition of upper urinary tract and renal function in 44 women with III grade cystocele and 49 women with IV grade cystocele using ultrasound examination, intravenous pyelography and renoradiography.

Results: among patients with III grade cystocele 21 (47,8%) were diagnosed with unilateral or bilateral hydroureteronephrosis of various degree and in 35 (79,5%) unilateral or bilateral renal dysfunction was found. Among patients with IV grade cystocele unilateral or bilateral hydroureteronephrosis and renal dysfunction were found in 43 (87,7%) and 46 (93,9%) subjects, respectively. All women underwent surgical treatment of cystocele using vaginal extraperitoneal colpopexy with synthetic graft using the Prolift anterior principle. At 6-8 months after the surgery upper urinary tract and renal function were evaluated in patients who had hydroureteronephrosis preoperatively, and patients who had impaired renal function. Among 21 patients with grade IIIcystocele complicated by unilateral or bilateral hydroureteronephrosis, urine passage was completely restored in 17 (80,9%) patients. Among 35 patients with impaired renal function at baseline, after surgery renal function recovered in 29 (82,8%) patients. Among 43 patients with grade IV cystocele complicated by unilateral or bilateral hydroureteronephrosis, urine passage was restored in 34 (79,1%) patients, and in 46 patients with impaired renal function prior to surgery it recovered in 26 (56,5%).

Conclusion: surgical management of grade III-IV cystocele complicated by hydroureteronephrosis and / or renal dysfunction allows to restore urine passage and renal function in most cases.

For citation: Nechiporenko A.N., Nechiporenko N.A., Yutsevich G.V. Сondition of the kidneys and ureters in women with cystocele. Experimental and clinical urology 2019;(3):164-169