title: Clinical and urodynamic assessment in patients with pelvic organ prolapse before and after laparoscopic sacrocolpopexy.
abstract: OBJECTIVE
  We hypothesized that patient-reported urinary symptoms and urodynamic evaluation improve after laparoscopic sacrocolpopexy (LSC) despite deeper vesicovaginal space dissection.
  
  
  METHODS
  This was a retrospective study of women with pelvic organ prolapse who underwent LSC from January 2013 to January 2016 in a tertiary center. Urinary function was clinically evaluated using the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), the Overactive Bladder Symptom Score (OABSS) and the Pelvic Floor Distress Inventory Questionnaire- - Short Form 20 (PFDI-20). Urodynamic assessment was performed before and 6 months after surgery. The Wilcoxon signed-ranks test and the McNemar test were applied with p < 0.05 considered significant.
  
  
  RESULTS
  A total of 155 patients were included in the study. Of these, 46 had urodynamic assessment before and after LSC. There were significant improvements after LSC in urodynamic storage phase parameters (higher volume at first desire, higher volume at strong desire, and larger bladder capacity) and voiding phase parameters (higher Qmax, higher Qave, lower PdetQmax, increased voided volume and reduced postvoid residual urine volume). Clinically, there was a significant increase after LSC in stress urinary incontinence and a significant reduction in urgency urinary incontinence, overactive bladder and voiding dysfunction.
  
  
  CONCLUSIONS
  Apart from increased stress urinary incontinence, there was an improvement in overall urinary function in terms of patient-reported symptoms and urodynamics, despite deep vesicovaginal space dissection. Hence, LSC is a viable surgical option for pelvic organ prolapse, restoring both level 1 and level 2 support without detrimental effects on urinary function.
authors.affiliation: Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan. bahiyah@salam.uitm.edu.my.|Maternofetal and Embryo (MatE) Research Group, Health and Wellbeing CoRe, Universiti Teknologi MARA (UiTM), 40450, Shah Alam, Selangor, Malaysia. bahiyah@salam.uitm.edu.my.|Discipline of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia. bahiyah@salam.uitm.edu.my.
authors.forename: Bahiyah
authors.identifier: http://orcid.org/0000-0002-6102-8344
authors.initials: B
authors.lastname: Abdullah
authors.affiliation: Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Nomura
authors.affiliation: Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Moriyama
authors.affiliation: Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan.
authors.forename: Tingwen
authors.initials: T
authors.lastname: Huang
authors.affiliation: Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan.
authors.forename: Shino
authors.initials: S
authors.lastname: Tokiwa
authors.affiliation: Urogynaecology Unit, Kameda Medical Center, 929, Higashi-cho, Kamogawa City, Chiba Prefecture, 296-8602, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Togo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D014563:Urodynamics
keywords: LSC; LUTS; POP