title: Sequential urodynamic assessment before and after laparoscopic sacrocolpopexy.
abstract: OBJECTIVE
  Controversial data are available as to whether to perform a simultaneous abdominal or vaginal colposuspension operation in laparoscopic sacrocolpopexy procedures. We wanted to evaluate the effect of a modified laparoscopic operation technique on urodynamic parameters and lower urinary tract symptoms.
  
  
  METHODS
  Prospective single center cohort study.
  
  
  METHODS
  Teaching hospital.
  
  
  METHODS
  Forty-nine consecutive patients who underwent a modified laparoscopic sacrocolpopexy/hysteropexy operation using bone anchor fixation and synthetic mesh, performed by the same laparoscopic surgeons.
  
  
  METHODS
  Pre- and postoperative multichannel urodynamic evaluation and validated questionnaires. The same urologist, blinded to the results of the questionnaire survey, interpreted all urodynamic evaluations.
  
  
  METHODS
  The effects of surgery on pelvic anatomy and patient satisfaction, urodynamic observations and diagnoses and symptom scores in validated questionnaires.
  
  
  RESULTS
  Forty-two patients consented to pre- and postoperative urodynamic evaluation. Laparoscopic sacrocolpopexy successfully corrected vaginal vault prolapse in all 42 patients with urodynamic evaluation six months after surgery. The bladder volume at first desire to void was significantly increased and the maximal detrusor pressure at voiding phase was significantly decreased. In the questionnaires, irritative and storage voiding symptoms were significantly decreased.
  
  
  CONCLUSIONS
  The results of the study demonstrate that there are no adverse urodynamic findings following this modified technique for laparoscopic sacrocolpopexy. The statistically significant urodynamic improvements are in accordance with the scores on the Urogenital Distress Inventory questionnaires. These results do not support a simultaneous routine prophylactic colposuspension procedure.
authors.affiliation: Department of Urology, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Maxime T M
authors.initials: MT
authors.lastname: Kummeling
authors.forename: John B W
authors.initials: JB
authors.lastname: Rietbergen
authors.forename: Mariëlla I J
authors.initials: MI
authors.lastname: Withagen
authors.forename: Guido H H
authors.initials: GH
authors.lastname: Mannaerts
authors.forename: Robin M F
authors.initials: RM
authors.lastname: van der Weiden
mesh_terms: D000328:Adult; D000368:Aged; D003127:Colposcopy / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000503:physiopathology* / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D013526:Surgical Mesh; D053441:Suture Anchors; D014563:Urodynamics; D014621:Vagina / Q000601:surgery