Comparison of Postoperative Urinary Storage Function Following Laparoscopic Sacrocolpopexy and Transvaginal Mesh Surgery Using Nearest-neighbor Propensity Score Matching Analysis.

Abstract

Objectives: Laparoscopic sacrocolpopexy (LSC) and transvaginal mesh surgery (TVM) have been shown to effectively treat pelvic organ prolapse (POP). However, their effects on urinary incontinence (UI) remain unknown, particularly when conducted on patient groups with similar backgrounds. We here aimed to compare the postoperative UI-related symptoms between patient groups without preoperative statistical differences.

Materials and methods: We retrospectively evaluated 243 patients with POP who underwent LSC or TVM at our hospital. Ninety-six patients were treated by LSC, whereas 147 were treated by TVM. After using nearest-neighbor propensity score matching, we compared the postoperative UI-related symptoms between the matched 67 LSC-treated patients and 67 TVM-treated patients.

Results: Following propensity score matching, the matched LSC and TVM groups did not demonstrate significant differences in terms of the explanatory factors. In both matched groups, the overactive bladder symptom score (OABSS) and International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) score were significantly decreased at 3-12 months postoperatively compared with preoperative variables. The 60-min pad weight test revealed a significant decrease in the LSC and TVM groups at 12 months postoperatively. When comparing the results at 1 year postoperatively with preoperative values, the matched LSC and TVM groups demonstrated no significant differences in changes of the 60-min pad weight, OABSS, and ICIQ-SF score.

Conclusion: TVM appears to be a more favorable option for managing all types of POP than LSC, considering its shorter operative time and lower complication rate, as shown using nearest-neighbor propensity score matching analysis.