Literature has revealed that symptoms of pelvic organ prolapse (POP) are an independent risk of symptomatic overactive bladder. Anterior vaginal wall prolapse is associated with overactive bladder and directly correlated to overactive bladder severity. However, different anterior vaginal wall prolapse stages might cause divergent effects on urinary incontinence. Relationships between POP staging and lower urinary tract symptoms are controversial. We evaluated correlations of POP staging in different compartments with lower urinary tract symptoms (LUTS)

From January 2016 to December 2017, 286 consecutive patients with urogynecologic complaints who were referred to our urodynamic unit were recruited into this study.  We excluded 33 patients who had a hysterectomy. In total, 252 patients’ demographic data, LUTS and POP stages were analyzed. Different stages of different compartments (anterior, cervix and posterior) of POPs according to IUGA and ICS terminology (as standardized in 1996) were re-grouped into four categories as stage 0, 1, 2, and 3 (including stage 4 because of a limited number of patients in stage 4). Pearson correlation coefficient was used to find correlations between different compartments of POP and LUTS (stress urinary incontinence, overactive bladder and voiding difficulty). General linear regression was used to evaluate factors associated with the occurrence of overactive bladder. A p value less than 0.05 was considered as a significant difference.

Only the Pearson correlation of overactive bladder and different compartments of POP were equal to or larger than 0.3 (moderate relationship; anterior vaginal wall was -0.3116, cervix was -0.2954 and posterior vaginal wall was -0.3779 ; all p < 0.05). Further, we found that stage 1 of anterior vaginal wall prolapse significantly increased (39.6%) the occurrence of overactive bladder compared to no prolapse. However, posterior compartment prolapse had a lower occurrence of overactive bladder (stage 1 reduced by 35.8%, stage 2 reduced by 31.2%, stage 3 reduced by 58% compared to no posterior vaginal wall prolapse (Table 1).

Interpretation of results		Our results imply that only stage 1 of anterior vaginal wall prolapse is associated with an increase in overactive bladder and posterior compartment prolapse may reduce occurrence of overactive bladder. Stress urinary incontinence and voiding difficulty had no correlation to any compartment of POP.

The correlation between POP with LUTS is weak except for overactive bladder.

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