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

Low Urin Tract Symptoms. 2021 Jul;13(3):341-346. doi: 10.1111/luts.12373. Epub 2021 Mar 11.

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.

Keywords: anti-incontinence surgery; laparoscopic sacrocolpopexy; midurethral sling; occult; stress urinary incontinence.

MeSH terms

  • Female
  • Humans
  • Laparoscopy*
  • Pelvic Organ Prolapse* / surgery
  • Retrospective Studies
  • Suburethral Slings*
  • Urinary Incontinence, Stress* / etiology
  • Urinary Incontinence, Stress* / surgery