Short‐term results of stress urinary incontinence in women undergoing laparoscopic sacrocolpopexy with and without midurethral sling

Abstract

Objectives: This study aimed to assess the short-term results of stress urinary incontinence (SUI) in women undergoing laparoscopic sacrocolpopexy (LSC) with and without midurethral sling (MUS). Methods: This retrospective study was conducted from July 2012 to December 2017. Women with stage 3 or 4 in the Pelvic Organ Prolapse Quantification (POP-Q) who underwent LSC were recruited. Multichannel urodynamic studies were performed in all women. Assessment included pre-and postoperative POP-Q stages, urodynamic parameters, peri-and postoperative complications, and symptoms. Results: One hundred and eighteen patients met the inclusion criteria in total. A total of 19.5% (23/118) of them had concomitant MUS. The mean follow-up duration was 16.9 ± 16.0 (range 3-69) months. Meanwhile, 33.9% (40/118) of the patients were diagnosed with overt SUI, and 50% (20/40) underwent MUS. In the concomitant MUS group, the rate of having postoperative SUI was only 5% (1/20). Patients diagnosed with SUI and without concomitant MUS had a 45% rate (9/20), and 25% of them (5/20) received MUS later. Preoperatively, 16.1% (19/118) of the patients were diagnosed with occult SUI. Among the patients without anti-incontinence sling during prolapse surgery, 25% (4/16) of them complained about having SUI during the follow-up. However, none of the women required subsequent anti-incontinence surgery. Postoperative de novo SUI occurred to 13.6% (16/118) of them. None of the patients received further operation. Based on the preoperative and postoperative urodynamic studies in the combination surgery group, a significant improvement was observed in the pad test.Conclusions: The combination of LSC with MUS procedure is likely to be beneficial in selected patients.

Laparoscopic pectopexy: the learning curve and comparison with laparoscopic sacrocolpopexy

“…Four of them were diagnosed as having occult SUI according to the preoperative urodynamic study. Occult SUI is a known risk factor for postoperative SUI in the case of POP surgery without a concomitant anti-incontinence procedure [ 9 ]. None of our patients reported de novo urgency or unusual lower urinary tract symptoms.…”

“…The Y-shaped mesh was sutured to the anterior and posterior cervix and vagina with 1–O V-Loc™. The upper end of the Y-shaped mesh was fixed with two or three 2–O Ethibond sutures to the anterior longitudinal ligament [ 9 ].…”

Efficacy of minimally invasive pectopexy with concomitant I‐stop‐mini sling for women with pelvic organ prolapse and overt stress urinary incontinence: A retrospective cohort study

“…For the primary endpoint, we assumed that there were no differences in the objective outcomes and subjective success between the two groups. In a previous study, 3 the operative time was significantly shorter for laparoscopic pectopexy than for sacrocolpopexy (182.9 ± 27.2 vs 256.2 ± 45.5 min). Due to the difficulty of sample size calculation according to no difference of the primary outcome, we demonstrated sample size calculation by the operative time.…”

“…Pelvic organ prolapse (POP) is a prevalent problem with a lifetime risk of 20% at 80 years of age 1 . Approximately 40% of women undergoing POP surgery may need concomitant anti‐incontinence surgery for persisting or de novo stress urinary incontinence (SUI) 2,3 . The risk of de novo SUI is higher in women with occult SUI, and a positive cough stress test is only detectable with prolapse reduction in urodynamic studies 4,5 .…”

“…1 Approximately 40% of women undergoing POP surgery may need concomitant anti-incontinence surgery for persisting or de novo stress urinary incontinence (SUI). 2,3 The risk of de novo SUI is higher in women with occult SUI, and a positive cough stress test is only detectable with prolapse reduction in urodynamic studies. 4,5 In women with occult SUI, pelvic reconstruction with concomitant anti-incontinence surgery resulted in significantly…”