Comparison of Postoperative Voiding and 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) are both established surgical interventions for pelvic organ prolapse (POP). Although both procedures demonstrate favorable anatomical outcomes, their comparative effects on postoperative voiding and storage function remain unclear, particularly in well-matched patient cohorts. This study aimed to evaluate postoperative urinary function following LSC and TVM using propensity score matching to adjust for baseline characteristics.

Materials and methods: We retrospectively evaluated 241 patients with POP who underwent LSC (n = 94) or TVM (n = 147) at our hospital. Propensity score matching was performed using age, body mass index, presence of diabetes mellitus, number of previous laparotomies, and POP stage as covariates. Postoperative voiding and storage outcomes were assessed using postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS), quality of life (QOL) score, and 60-min pad weight tests preoperatively and at 3, 6, and 12 months postoperatively.

Results: After matching, no significant differences were observed between the LSC and TVM groups in baseline characteristics. Both groups demonstrated significant postoperative improvements in PVR, IPSS, and QOL scores at all follow-up points compared with preoperative values. Moreover, no significant differences were noted between the two groups in changes from baseline to 12 months postoperatively in PVR, IPSS, and QOL scores, or pad test results.

Conclusion: Both techniques significantly improved voiding and storage symptoms when matched for baseline characteristics. Given the shorter operative time and lower complication rate, TVM may be a sufficient and effective option for the surgical management of POP.