The Saudi Journal of Medical Insights

Background: Overactive bladder (OAB) and pelvic organ prolapse (POP) are common coexisting pelvic floor disorders,
though their relationship is not fully understood.
Objective: To synthesize evidence on the POP–OAB association, focusing on OAB prevalence in POP, compartment
specific links, treatment outcomes, and predictors of persistent symptoms.
Methods: A systematic search of PubMed, Embase, Scopus, Web of Science, and Cochrane Library (2021–2025) identified
studies on women with POP and OAB using validated measures. Two reviewers independently screened, extracted data,
and assessed bias (Newcastle-Ottawa Scale, JBI checklists). Narrative synthesis was used due to heterogeneity.
Results: Fifteen studies (seven prospective cohorts, four retrospective, two case-control, two cross-sectional) were
included. OAB prevalence in POP was markedly elevated (up to 70%). Anterior and apical prolapse showed stronger OAB
associations than posterior. POP treatment improved OAB symptoms in 58–89% of patients, with anterior/apical repair
yielding higher resolution (e.g., 82% for frequency) versus posterior (63%). Persistent OAB predictors included
preoperative detrusor overactivity (OR 12.2), urgency incontinence (OR 3.8), BMI >25 (OR 1.8), and advanced anterior
prolapse (OR 2.28). De novo OAB occurred in 1–5% postoperatively.
Conclusion: A significant association exists between POP and OAB, especially for anterior/apical defects. Most patients
experience OAB improvement after POP treatment. Clinicians should routinely assess OAB in POP patients and consider
POP repair as part of OAB management. Future research needs standardized prospective studies to clarify mechanisms and
build predictive models for personalized care.