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Clinical and urodynamic assessment in patients with pelvic organ prolapse before and after laparoscopic sacrocolpopexy

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Abstract

Introduction and hypothesis

We hypothesized that patient-reported urinary symptoms and urodynamic evaluation improve after laparoscopic sacrocolpopexy (LSC) despite deeper vesicovaginal space dissection.

Methods

This was a retrospective study of women with pelvic organ prolapse who underwent LSC from January 2013 to January 2016 in a tertiary center. Urinary function was clinically evaluated using the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF), the Overactive Bladder Symptom Score (OABSS) and the Pelvic Floor Distress Inventory Questionnaire- – Short Form 20 (PFDI-20). Urodynamic assessment was performed before and 6 months after surgery. The Wilcoxon signed-ranks test and the McNemar test were applied with p < 0.05 considered significant.

Results

A total of 155 patients were included in the study. Of these, 46 had urodynamic assessment before and after LSC. There were significant improvements after LSC in urodynamic storage phase parameters (higher volume at first desire, higher volume at strong desire, and larger bladder capacity) and voiding phase parameters (higher Q max, higher Q ave, lower P det Q max, increased voided volume and reduced postvoid residual urine volume). Clinically, there was a significant increase after LSC in stress urinary incontinence and a significant reduction in urgency urinary incontinence, overactive bladder and voiding dysfunction.

Conclusions

Apart from increased stress urinary incontinence, there was an improvement in overall urinary function in terms of patient-reported symptoms and urodynamics, despite deep vesicovaginal space dissection. Hence, LSC is a viable surgical option for pelvic organ prolapse, restoring both level 1 and level 2 support without detrimental effects on urinary function.

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Authors and Affiliations

  1. Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan

    Bahiyah Abdullah, Jimmy Nomura, Shingo Moriyama, Tingwen Huang, Shino Tokiwa & Mio Togo

  2. Maternofetal and Embryo (MatE) Research Group, Health and Wellbeing CoRe, Universiti Teknologi MARA (UiTM), 40450, Shah Alam, Selangor, Malaysia

    Bahiyah Abdullah

  3. Discipline of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia

    Bahiyah Abdullah

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  1. Bahiyah Abdullah
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  2. Jimmy Nomura
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  3. Shingo Moriyama
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  4. Tingwen Huang
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Correspondence to Bahiyah Abdullah.

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Abdullah, B., Nomura, J., Moriyama, S. et al. Clinical and urodynamic assessment in patients with pelvic organ prolapse before and after laparoscopic sacrocolpopexy. Int Urogynecol J 28, 1543–1549 (2017). https://doi.org/10.1007/s00192-017-3306-7

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  • DOI: https://doi.org/10.1007/s00192-017-3306-7

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