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.

Objectives Pelvic organ prolapse (POP) is relatively common in the elderly population. Laparoscopic sacrocolpopexy (LSC) has been reported by several studies to be a less invasive treatment option as compared to open sacrocolpopexy. However, almost all prior reports focused on the complications or surgical obstacles. The present study was designed to examine POP patients of all ages and assess lower urinary tract function before and after LSC. Methods This retrospective study examined the results of LSC performed in POP patients. Urodynamic studies were performed pre‐ and postoperatively in 50 patients, with the subjects divided into two groups containing those less than and those older than 65 years of age. We performed a pressure flow study. We examined bladder functions by evaluating bladder capacity, detrusor pressure at maximum flow (PdetQmax), maximum flow rate (Qmax), normal desire to void, strong desire to void, voided volume, and postvoid residual volume (PVR). Statistical analysis was performed using Wilcoxon signed rank test. Values of P < .05 were considered significant. Results With regard to the pressure‐flow study parameters, there was a significant increase in the normal desire to void and bladder capacity only in the ≥65 age group. After the operation, there was a significant increase in the mean postoperative Qmax and voided volume, while there was a significant decrease in the PdetQmax and PVR as compared to the preoperative values only in the ≥65 age group. Conclusions Results show that in elderly patients with POP, LSC might be a valid option with regard to potentially regaining urinary tract function.

Abbreviations & Acronyms ASIS = anterior superior iliac spine LLS = laparoscopic lateral suspension LSC = laparoscopic sacrocolpopexy POP = pelvic organ prolapse POP-Q = POP quantification Correspondence: Tokumasa

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Objectives: Laparoscopic sacrocolpopexy is often performed to treat pelvic organ prolapse. Preoperative stress urinary incontinence (SUI) can improve after laparoscopic sacrocolpopexy. In contrast, some patients without incontinence preoperatively develop SUI after pelvic organ prolapse repair (ie, de novo SUI). This study aimed to identify the preoperative predictive factors of de novo SUI after laparoscopic sacrocolpopexy.Methods: A total of 858 patients underwent laparoscopic sacrocolpopexy between January 2013 and November 2017 at Kameda Medical Center. Urodynamic studies were performed pre-and postoperatively on 75 patients. This retrospective study included 43 of 75 patients who did not have SUI preoperatively. We assessed urethral function according to functional profile length and maximum urethral closure pressure. We evaluated voiding function in terms of maximum flow rate, detrusor pressure at maximum flow rate, and postvoid residual volume. Furthermore, each factor was compared between de novo SUI-positive and SUI-negative groups.Results: After laparoscopic sacrocolpopexy, 30 (69.8%) patients presented with SUI.The preoperative maximum urethral closure pressure was significantly lower in the de novo SUI-positive group (36.0 cmH 2 O) than in the de novo SUI-negative group (50.5 cmH 2 O, P = .020). More patients with maximum urethral closure pressure <40 cmH 2 O had de novo SUI than patients with maximum urethral closure pressure ≥40 cmH 2 O (P = .004). There were no significant differences between preoperative maximum urethral closure pressure and postoperative maximum urethral closure pressure in either group.Conclusions: Low preoperative maximum urethral closure pressure, particularly maximum urethral closure pressure <40 cmH 2 O, is a predictor of de novo SUI after laparoscopic sacrocolpopexy.

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