Derya KILIÇ
Pelviperineology - 2026;45(1):39-43
Objective: To examine the relationship between nocturia, pelvic organ support, and bladder neck mobility by perineal ultrasonography in women with nocturia Materials and Methods: In this case-control study, 62 women presenting with nocturia were compared with 62 matched controls without nocturia. Groups were matched for age, body mass index (BMI), and apical prolapse (C point). Pelvic organ prolapse was graded using the pelvic organ prolapse quantification system system, and bladder neck descent during the Valsalva maneuver was measured by perineal ultrasonography. The coexistence of stress urinary incontinence (SUI) was documented. A pre-specified subgroup analysis was then performed after excluding patients with SUI to isolate the nocturia-specific results. Results: Baseline characteristics including age, BMI, and apical prolapse were similar between groups. Women with nocturia had significantly higher gravidity and more vaginal deliveries than controls. Posterior compartment measurements (Ap and Bp points) were significantly greater in the nocturia group, while anterior wall measurements did not differ. Bladder neck descent during Valsalva was also greater among women with nocturia. SUI co-occurred in 79% of the nocturia group versus 38.7% of controls. When SUI cases were excluded, posterior vaginal wall defects remained to be associated with nocturia, whereas the significance in bladder neck descent disappeared. Conclusion: Nocturia appears to be associated with posterior vaginal wall support defects and increased bladder neck mobility. When cases with SUI are removed from the analysis, posterior compartment abnormalities persist while the bladder neck mobility difference resolves pointing to a mechanism that is at least partly independent of urethral hypermobility. These findings are consistent with Integral Theory.
