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Changes in voiding function after laparoscopic sacrocolpopexy for advanced pelvic organ prolapse: a cohort study of 76 cases

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Abstract

Introduction and hypothesis

We evaluated changes in voiding function at 3 months after laparoscopic sacrocolpopexy (LSC) for advanced pelvic organ prolapse (POP) patients and identified risk predictors for postoperative voiding dysfunction.

Methods

Seventy-six patients with advanced POP who underwent LSC were enrolled in this retrospective cohort study. Pre- and postoperative objective voiding function was assessed by uroflowmetry plus postvoid residual (PVR) volumes. Voiding dysfunction was defined as a maximum flow rate (Qmax) < 15 ml/s, average flow rate (Qave) < 10 ml/s, or PVR > 50 ml. Statistical analyses were performed using paired-sample t tests, McNemar’s tests, and multivariate regression analyses.

Results

Thirty patients (39%) showed evidence of voiding dysfunction preoperatively, but two thirds of these patients were asymptomatic. Voiding dysfunction decreased significantly from baseline to 3 months after surgery (39% vs. 21%, p = 0.009), including a decrease among patients with Qave < 10 ml/s (32% vs. 17%, p = 0.043) and PVR > 50 ml (24% vs. 9%, p = 0.019). Voiding difficulty decreased significantly from baseline to 3 months after surgery (32% vs. 9%, p < 0.001); urgency and urinary incontinence symptoms did not exhibit significant improvement (p > 0.05). Multivariate analysis identified Qave < 10 ml/s as the independent predictor of postoperative voiding dysfunction [p = 0.014, odds ratio (OR) = 4.77, 95% confidence interval (CI) 1.37–16.54].

Conclusions

Preoperative voiding dysfunction is common among patients with POP and significantly improves at 3 months following LSC. A preoperative Qave < 10 ml/s was an independent risk factor for postoperative voiding dysfunction.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Road, Dongcheng District, Beijing, People’s Republic of China, 100730

    Xiao-Chen Song, Lan Zhu & Shuo Liang

  2. Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China

    Tao Xu

Authors
  1. Xiao-Chen Song
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  2. Lan Zhu
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Corresponding author

Correspondence to Lan Zhu.

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Funding

No funding was received.

Conflict of interest

Lan Zhu: currently receiving clinical research grant from the Chinese Government under the 5-year National Project (Number 2014BAI05B02) and National Natural Science Foundation of China (Number 81370697).

Xiao-Chen Song, Shuo Liang and Tao Xu: no conflict of interests.

Institutional review board

The hospital’s ethics committee approved this study (S-K 077).

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Song, XC., Zhu, L., Liang, S. et al. Changes in voiding function after laparoscopic sacrocolpopexy for advanced pelvic organ prolapse: a cohort study of 76 cases. Int Urogynecol J 29, 505–512 (2018). https://doi.org/10.1007/s00192-017-3412-6

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  • DOI: https://doi.org/10.1007/s00192-017-3412-6

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