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Hydronephrosis Associated With Pelvic Organ Prolapse

A Systematic Review

Siddique, Moiuri MD, MPH*; Ingraham, Caitlin MD; Kudish, Bela MD; Iglesia, Cheryl B. MD§; Polland, Allison MD

Female Pelvic Medicine & Reconstructive Surgery: January 4, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000683
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Objectives The aim of this study was to report the prevalence of hydronephrosis associated with pelvic organ prolapse (POP).

Methods We conducted a MEDLINE and PubMed search from 1996 to October 2016 using PRISMA guidelines. Eight studies met criteria for inclusion, including 3 prospective and 5 retrospective studies.

Results The prevalence of hydronephrosis ranged from 3.5% to 30.6% in studies that included multiple stages of prolapse. Hydronephrosis correlated with prolapse severity in multiple studies, but serum creatinine did not consistently predict hydronephrosis. Two studies reported a significantly higher prevalence of hydronephrosis in patients with uterovaginal prolapse compared with vaginal vault prolapse. Complete resolution of hydronephrosis was described in 56% to 83% of patients after undergoing surgical treatment for advanced prolapse.

Conclusions Hydronephrosis among patients with POP is not rare, and we suggest consideration of upper tract evaluation in patients presenting with POP, particularly in those with advanced uterovaginal prolapse electing to proceed with expectant or conservative management.

From the *Georgetown University/MedStar Washington Hospital Center, Washington, DC;

Christiana Care Health System, Newark, DE;

Department of Obstetrics and Gynecology, Florida Hospital, Oralndo, FL;

§Section of Female Pelvic Medicine and Reconstructive Surgery, Departments of Obstetrics and Gynecology and Urology, Georgetown University/MedStar Washington Hospital Center, Washington, DC; and

Departments of Urology and Obstetrics and Gynecology, Maimonides Medical Center/Zucker School of Medicine at Hofstra/Northwell, New York, NY.

Correspondence: Moiuri Siddique, MD, MPH, Georgetown University/MedStar Washington Hospital Center, 106 Irving St NW, POB 405 S, Washington, DC 20010. E-mail: moiuri.siddique@gunet.georgetown.edu.

The authors have declared they have no conflicts of interest.

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