Effect of Voiding Position on Uroflwmetry in Women with Anterior Vaginal Wall Prolapse Stage II and III

Objectives: To determine the effect of voiding position on uroflowmetry parameters in women with anterior vaginal wall prolapse stage II and IIIMaterials and Methods: A total of 51 women with anterior compartment prolapse stage II and III attending female pelvic medicine and reconstructive surgery clinic, Ramathibodi Hospital during June 2015 to April, 2016 were enrolled in the randomized controlled crossover study. After informed consent was obtained, participants were randomly allocated sequences of two voiding positions: sitting and modified squatting. The uroflowmetry was performed in both voiding positions for each participant. The post-void residual urine (PVR) volumes were measured using transabdominal ultrasound. Uroflowmetry parameters and PVR values were compared between the two different voiding positions. results: The mean age of the participants was 64.8 ± 9.1 years. The POP-Q staging was stage II in 30 (58.8%) and stage III in 21 (41.2%) women. There was no statistically significant difference in voided volume of women in sitting and modified squatting position which were 335.2 ± 160.1 and 362.7 ± 161.0 ml, respectively (p > 0.05). Mean maximum flow rate and mean average flow rate for the sitting (22.3 ± 11.2 and 10.7 ± 5.5 ml/s) and modified squatting position (23.8 ± 10.9 and 11.91 ± 6.4 ml/s) in the women were not significantly different (p > 0.05). PVR value in sitting voiding position was significant lower than in modified squatting position (52.6 ± 55.1 vs 75.0 ± 78.6) (p < 0.05).Conclusion: Voiding positions either sitting or modified squatting does not affect urinary flow rate in women with anterior wall prolapse. Voiding in modified squatting position may results in higher post-void residual urine