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51: Comparison of postoperative stress urinary incontinence following laparoscopic sacrocolpopexy and vaginal apical suspension in patients with negative preoperative prolapse reduction stress testing

      Objectives

      The objective of this study was to evaluate the difference in incidence of postoperative stress urinary incontinence (SUI) in patients who underwent laparoscopic sacrocolpopexy (SCP) versus those who underwent a vaginal apical suspension. Both groups had negative preoperative prolapse reduction stress testing (PPRST).

      Materials and Methods

      We analyzed a retrospective cohort of patients with negative PPRST who underwent laparoscopic SCP or vaginal apical suspension via uterosacral ligament suspension (USLS) or sacrospinous ligament fixation (SSLF) from 2013 to 2016 at a tertiary referral center. Negative PPRST was defined as an absence of SUI on either cough stress test or urodynamics with reduction of prolapse. SUI was defined by answering yes to the routine question “Do you leak urine with any type of activity including but not limited to coughing, laughing, sneezing or exercise?” Subjective symptoms of SUI were evaluated at postoperative visit intervals of two weeks, six weeks, six months, and one year.

      Results

      One hundred thirty-three patients were included in the final analysis, 74 patients in the laparoscopic SCP group and 69 patients in the vaginal apical suspension group. The vaginal group was composed of 62 patients who underwent USLS and 12 patients who underwent SSLF. The incidence of SUI was greatest at the six week postoperative visit with 4 patients in each group stating subjective symptoms (p > 0.99). The subjective SUI symptoms resolved in the laparoscopic SCP group at the 6 month and 1 year follow up. However, in the vaginal apical suspension group these symptoms continued in 3 patients at the 6 month and one year follow up visit (p = 0.245).