Laparoscopic sacrocolpopexy (LSC) is an increasingly popular treatment for pelvic organ prolapse (POP) because of its low recurrence rate and safety. Although LSC may improve the voiding function, it may also lead to de novo stress urinary incontinence. The detailed impact of LSC on voiding function and its mechanism remain unclear. Therefore, in this study, we evaluated the impact of LSC on voiding function prospectively by performing a pre- and post-operative urodynamic study in patients with stage 3 or greater POP.
Urinary status was evaluated before and 3 months after LSC. Pre- and post-operative evaluations included medical history, clinical examination, urodynamic studies, chain cystography, and residual urine volume measurement. Urinary symptoms were assessed using the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS).
The non-recurrence rate at 3 months was 82.3%. All recurrences involved bladder prolapse. Apart from the fact that there was no significant change in the OABSS, the improvement in IPSS suggests that subjective voiding symptoms have improved. Although the maximum urinary flow rate did not change significantly, the bladder volume at first sensation increased, urinary storage function improved, and residual urine volume decreased. There were no perioperative complications, and none of the patients complained of post-operative difficulty in urination or urinary retention. The retrovesical angle significantly decreased.
The modified LSC in women with POP provides good functional outcomes in terms of IPSS, post void residual volume (PVR), and urinary storage function.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi. 2021 Sep 14 [Epub ahead of print]
Yuka Toyama, Yasutomo Suzuki, Satoko Nakayama, Yuki Endo, Yukihiro Kondo, Masao Ichikawa, Shigeo Akira
Nippon Medical School, Department of Urology., Nippon Medical School, Department of Obstetrics and Gynecology.