6 Cases of De Novo Stress Urinary Incontinence after Single-Incision Laparoscopic Sacrocolpopexy: a Retrospective Analysis
IUGA Academy. Liu J. Jun 30, 2018; 212900; 496 Topic: Pelvic Organ Prolapse

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496

6 Cases of de novo stress urinary incontinence after single-incision laparoscopic sacrocolpopexy: a retrospective analysis

Liu, J1; Li, Y1; Fu, H1; Guan, X2

1: Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; 2: Baylor College of Medicine, Houston, Texas; Guangzhou Medical University, Guangzhou, Guangdong, China

Introduction: In a prospective cohort study, it was reported that 39% of pelvic organ prolapse(POP) concomitant stress urinary incontinence(SUI) were cured from SUI by POP surgery alone, and de novo SUI appeared in 22%. Sacral colpopexy(SC) is the gold standard for POP surgery. Its advantages are a therapy for multi-compartmental POP, a lower recurrent rate(6.2%) and higher satisfaction(94.4%). However, surgical correction of prolapse which released urethral obstruction and changed mechanism of pelvic pressure conduction results in de novo SUI. There are several approaches for SC: transabdominal, laparoscopic, robot-assisted, transvaginal and single-incision laparoscopic. It is reported that average morbidity of de novo SUI after laparoscopic sacrocolpopexy(LSC)(17.8%, range from 2.4% to 44%)is lower than abdominal sacral colpopexy(33%). Surgeons are plagued by postoperative urinary incontinence. Furthermore, it will reduce the quality of life of patient.

Objective: To assess morbidity of de novo SUI after single-incision laparoscopic sacrocolpopexy without anti-incontinence procedure, we carried out a single center retrospective analysis.

Methods: A total of 51 women with POP who underwent single-incision laparoscopic sacrocolpopexy without concomitant anti-incontinence surgery were collected from January 2016 to December 2017. Preoperative evaluation included physical examination, urodynamic stress test, a pelvic organ prolapse qualification assessment and a detailed urogynecological history. 3-24 months follow-up evaluation included postoperative POP-Q, cough stress test, urinary and fecal self-control ability, pain associated with surgery and patient satisfaction. Incontinence impact questionnaire short form(IIQ-7) was used to compare the patients’ quality of life before operation and after operation at 3 months and 6 months.

Results: None of 51 cases prolapse recurrence at 3 -24 months follow-up, and de novo SUI appeared in 11.76%(6 cases). However?4 of de novo SUI(66.7%) were cured spontaneously. Only 33.3%(2 cases) of de novo SUI needed a secondary TVT-O surgery.

Conclusions: The morbidity of de novo SUI after single-incision laparoscopic sacrocolpopexy was in 11.76%. Compared to LSC, it was not increased obviously. But further research will still be needed.

[1] Urinary Incontinence After Surgery for Pelvic Organ Prolapse.

[2] The current status of laparoscopic sacrocolpopexy?A Review.

[3] Validation ofincontinenceimpact questionnaire short form in Chinese population.

Disclosure:

Work supported by industry: no.

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