title: New onset stress urinary incontinence following laparoscopic sacrocolpopexy and its relation to anatomical outcomes.
abstract: OBJECTIVE
  The aim of this study was to assess the incidence of stress urinary incontinence (SUI) following laparoscopic sacrocolpopexy in continent women and its relation to postoperative prolapse stage.
  
  
  METHODS
  A total of 220 continent women with symptomatic apical prolapse who underwent laparoscopic sacrocolpopexy were prospectively evaluated; 100 women had previous hysterectomy. Patients were followed up at 3 and 12 months after surgery. All subjects completed the King's Health Questionnaire (KHQ) and Prolapse Quality of Life Questionnaire (P-QOL) and were examined using the Pelvic Organ Prolapse Quantification (POP-Q) system. The primary outcome measure was the number of women who developed new onset moderate/severe SUI at 3 and 12 months postoperatively and its relation to postoperative prolapse stage.
  
  
  RESULTS
  At 3 months, 52 women (23.6 %) developed moderate/severe SUI; 27 (12.2 %) had severe SUI. Eleven women (5.0 %) underwent surgery for SUI within 6 months of sacrocolpopexy. All surgery for SUI was in women who had post-hysterectomy sacrocolpopexy. Postoperatively, the vaginal apex (point C) was at stage 0/I in 195 cases (88.6 %). There were no differences in postoperative POP-Q stage of the anterior and apical vaginal walls between continent women and those with SUI (p = 0.45). The posterior vaginal wall was higher in women who developed de novo SUI (p = 0.03).
  
  
  CONCLUSIONS
  The incidence of SUI following apical prolapse repair is 23.6 %. Subsequent continence procedures were performed in 5.0 % of patients. All were in women who had previous hysterectomy making the risk in this group 11 %. Higher POP-Q stage of the posterior vaginal wall was associated with SUI.
authors.affiliation: Urogynaecology Unit, Luton and Dunstable University Hospital, Luton, UK.
authors.forename: Dina
authors.initials: D
authors.lastname: El Hamamsy
authors.forename: Abdalla M
authors.initials: AM
authors.lastname: Fayyad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D014550:Urinary Incontinence, Stress / Q000209:etiology*; D014596:Uterine Prolapse / Q000601:surgery*; D055815:Young Adult