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International Urogynecology Journal
Published in: International Urogynecology Journal 4/2018

01-04-2018 | Original Article

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

Authors: Xiao-Chen Song, Lan Zhu, Shuo Liang, Tao Xu

Published in: International Urogynecology Journal | Issue 4/2018

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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.
Literature
1.
Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V. The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG : an international journal of obstetrics and gynaecology. 2005;112(7):971–6.CrossRef
2.
Choi YS, Kim JC, Lee KS, Seo JT, Kim HJ, Yoo TK, et al. Analysis of female voiding dysfunction: a prospective, multi-center study. Int Urol Nephrol. 2013;45(4):989–94.CrossRefPubMed
3.
Haylen BT, Krishnan S, Schulz S, Verity L, Law M, Zhou J, et al. Has the true prevalence of voiding difficulty in urogynecology patients been underestimated? Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(1):53–6.CrossRefPubMed
4.
Ganatra AM, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009;55(5):1089–103.CrossRefPubMed
5.
Costantini E, Mearini L, Lazzeri M, Bini V, Nunzi E, di Biase M, et al. Laparoscopic versus abdominal Sacrocolpopexy: a randomized. Controlled Trial The Journal of urology. 2016;196(1):159–65.PubMed
6.
Zhu L, Sun Z, Yu M, Li B, Li X, Lang J. Modified laparoscopic sacrocolpopexy with mesh for severe pelvic organ prolapse. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2013;121(2):170–2.CrossRef
7.
Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol. 2004;190(1):20–6.CrossRefPubMed
8.
Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An international Urogynecological Association (IUGA) / international continence society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016;27(2):165–94.CrossRefPubMed
9.
Costantini E, Mearini E, Pajoncini C, Biscotto S, Bini V, Porena M. Uroflowmetry in female voiding disturbances. Neurourol Urodyn. 2003;22(6):569–73.CrossRefPubMed
10.
Coates KW, Harris RL, Cundiff GW, Bump RC. Uroflowmetry in women with urinary incontinence and pelvic organ prolapse. Br J Urol. 1997;80(2):217–21.CrossRefPubMed
11.
Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13.CrossRefPubMed
12.
Casteleijn NF, Panman CM, Wiegersma M, Kollen BJ, Messelink EJ, Dekker JH. Free uroflowmetry for voiding dysfunction measurement in women with pelvic organ prolapse and urinary incontinence in primary care. International journal of urology : official journal of the Japanese Urological Association. 2015;22(8):801–2.CrossRef
13.
Lo TS, Shailaja N, Hsieh WC, Uy-Patrimonio MC, Yusoff FM, Ibrahim R. Predictors of voiding dysfunction following extensive vaginal pelvic reconstructive surgery. International urogynecology journal. 2016.
14.
Bump RC, Hurt WG, Theofrastous JP, Addison WA, Fantl JA, Wyman JF, et al. Randomized prospective comparison of needle colposuspension versus endopelvic fascia plication for potential stress incontinence prophylaxis in women undergoing vaginal reconstruction for stage III or IV pelvic organ prolapse. The continence program for women research group. Am J Obstet Gynecol. 1996;175(2):326–33. discussion 33-5 CrossRefPubMed
15.
Colombo M, Maggioni A, Scalambrino S, Vitobello D, Milani R. Surgery for genitourinary prolapse and stress incontinence: a randomized trial of posterior pubourethral ligament plication and Pereyra suspension. Am J Obstet Gynecol. 1997;176(2):337–43.CrossRefPubMed
16.
Colombo M, Maggioni A, Zanetta G, Vignali M, Milani R. Prevention of postoperative urinary stress incontinence after surgery for genitourinary prolapse. Obstet Gynecol. 1996;87(2):266–71.CrossRefPubMed
17.
de Tayrac R, Mathe ML, Bader G, Deffieux X, Fazel A, Fernandez H. Infracoccygeal sacropexy or sacrospinous suspension for uterine or vaginal vault prolapse. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2008;100(2):154–9.CrossRef
18.
Natale FMA, Panei M, Weir J, Antomarchi F, Cervigni M. Prospective randomized controlled study between two different procedures to suspend the vaginal vault: high levator myorrhaphy and uterosacral vaginal vault suspension (abstract number 6). Neurourol Urodyn. 2007;26(5):608–9.
19.
Fitzgerald MP, Kulkarni N, Fenner D. Postoperative resolution of urinary retention in patients with advanced pelvic organ prolapse. Am J Obstet Gynecol. 2000;183(6):1361–3. discussion 3-4 CrossRefPubMed
20.
Kummeling MT, Rietbergen JB, Withagen MI, Mannaerts GH, van der Weiden RM. Sequential urodynamic assessment before and after laparoscopic sacrocolpopexy. Acta Obstet Gynecol Scand. 2013;92(2):172–7.CrossRefPubMed
21.
Parys BTHB, Woolfenden KA, Parsons KF. Vesico-urethral dysfunction after simple hysterectomy. Neurourol Urodyn. 1989;8:315–6.
22.
Dubernard G, Rouzier R, David-Montefiore E, Bazot M, Darai E. Urinary complications after surgery for posterior deep infiltrating endometriosis are related to the extent of dissection and to uterosacral ligaments resection. J Minim Invasive Gynecol. 2008;15(2):235–40.CrossRefPubMed
23.
Butler-Manuel SA, Buttery LD, A’Hern RP, Polak JM, Barton DP. Pelvic nerve plexus trauma at radical and simple hysterectomy: a quantitative study of nerve types in the uterine supporting ligaments. J Soc Gynecol Investig. 2002;9(1):47–56.CrossRefPubMed
24.
Salin A, Conquy S, Elie C, Touboul C, Parra J, Zerbib M, et al. Identification of risk factors for voiding dysfunction following TVT placement. Eur Urol. 2007;51(3):782–7. discussion 7 CrossRefPubMed
25.
Zhang L, Zhu L, Liang S, Xu T, Lang J. Short-term effects on voiding function after mesh-related surgical repair of advanced pelvic organ prolapse. Menopause (New York, NY). 2015;22(9):993–9.CrossRef
Metadata
Title
Changes in voiding function after laparoscopic sacrocolpopexy for advanced pelvic organ prolapse: a cohort study of 76 cases
Authors
Xiao-Chen Song
Lan Zhu
Shuo Liang
Tao Xu
Publication date
01-04-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 4/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3412-6

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