Evaluation of lower urinary tract symptoms and sexual function after laparoscopic sacrocolpopexy

Abstract

Objective

This study aimed to investigate the effectiveness of laparoscopic sacrocolpopexy (LSCP) in the treatment of pelvic organ prolapse (POP), specifically its impact on the incidence of de novo stress urinary incontinence (SUI) and changes in sexual function.

Materials and methods

This cohort study involved 34 women with stage 3 and 4 POP who underwent LSCP between 2017 and 2022. Baseline and 6-month postoperative assessments were conducted using urodynamic studies and several various incontinence and prolapse questionnaires to assess LUTS, de novo SUI, sexual function, and quality of life. Subsequently, patients were evaluated every 6 months with bladder diaries and POP-Q quantification system assessment.

Results

LSCP led to significant improvements in POP, urinary frequency and SUI. Significant advancements were observed across 3 questionnaires: Incontinence Impact Questionnaire (IIQ-7), Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12). Of the 34 patients, 16.7 % (3/18) experienced de novo SUI and 2.9 % developed vaginal mesh exposure postoperatively. Risk elements for de novo SUI included a higher BMI and preoperative SUI. LSCP effectively alleviated LUTS, reducing urinary frequency from an average of 14.7 to 8.4 episodes per day (P = 0.009), and significantly improved prolapse symptoms and sexual function, as reflected in POPDI-6 and PISQ-12 scores.

Conclusions

LSCP demonstrates high efficacy in the treatment of POP, significantly ameliorating LUTS and sexual function, while maintaining a low complication rate. Notably, elevated BMI and preoperative SUI emerge as significant risk elements for the development of de novo SUI.