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Impact of sacrocolpopexy for the management of pelvic organ prolapse on voiding dysfunction and uroflowmetry parameters: a prospective cohort study

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Abstract

Purpose

Voiding difficulties in the context of pelvic organ prolapse are often neglected or underestimated. To date, there are heterogeneous data available on the outcome of a surgical correction of pelvic organ prolapse and the impact on concomitant voiding dysfunction. The primary aim of this study was to evaluate whether laparoscopic sacrocolpopexy would resolve preoperative voiding dysfunction and the impact on objective uroflowmetry parameters.

Methods

Data from 103 women undergoing sacrocolpopexy for prolapse stage ≥ II with concurrent objective and/or subjective voiding dysfunction were prospectively evaluated. All women underwent full urogynecological examination, and completed a validated questionnaire pre- and postoperatively. Objective uroflowmetry parameters and subjective outcome data regarding voiding functions were compared pre- and postoperatively.

Results

All points of the POP-Q system improved significantly pre- to postoperatively (p < 0.001). Preoperatively, 42 of 103 women showed a postvoid residual ≥ 100 ml, whereas only six women had a relevant postvoid residual postoperatively. In total, the postoperative postvoid residual in all women decreased significantly (p < 0.001). Voiding time decreased significantly postoperatively (p < 0.001) with no significant change in the voided volume (p = 0.352). The maximum flow rate increased postoperatively, reaching no statistically significant change (p = 0.132). Subjective outcome measurements (weak or prolonged stream, incomplete bladder emptying, and straining to void) improved significantly (p < 0.001 for all the questions).

Conclusion

Our prospective study demonstrates that sacrocolpopexy to correct pelvic organ prolapse can successfully resolve voiding dysfunction, as both objective and subjective parameters improved significantly after surgery.

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Funding

No financial support was provided for this project.

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Authors and Affiliations

  1. Department of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000, Lucerne 16, Switzerland

    Simone Aichner, Ivo Fähnle, Janine Frey & Corina Christmann-Schmid

  2. Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland

    Jörg Krebs

Authors
  1. Simone Aichner
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  2. Ivo Fähnle
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  3. Janine Frey
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  4. Jörg Krebs
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  5. Corina Christmann-Schmid
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Contributions

SA: project/protocol development, data collection and management, and manuscript writing. IF: data collection and management. JF: data collection and management. JK: data analysis and manuscript editing. CCS: project/protocol development, manuscript writing/editing, and supervision.

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Correspondence to Simone Aichner.

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The authors report no conflict of interest.

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The study was approved by the Local Ethics Committee (EKNZ 01676).

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All participants provided written informed consent.

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Aichner, S., Fähnle, I., Frey, J. et al. Impact of sacrocolpopexy for the management of pelvic organ prolapse on voiding dysfunction and uroflowmetry parameters: a prospective cohort study. Arch Gynecol Obstet 306, 1373–1380 (2022). https://doi.org/10.1007/s00404-021-06369-0

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  • DOI: https://doi.org/10.1007/s00404-021-06369-0

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