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[Impact of laparoscopic sacrocolpopexy, with or without a midurethral sling, on lower urinary tract symptoms].
Prog Urol. 2016 Jun; 26(7):401-8.PU

Abstract

OBJECTIVE

To evaluate the impact of laparoscopic sacrocolpopexy, with or without simultaneous midurethral sling (MUS), on urinary symptoms and health-related quality of life of patients.

MATERIALS

A prospective analysis was carried out including 83 women with symptomatic pelvic organ prolapse who had laparoscopic sacrocolpopexy between 2009 and 2011. Patients were classified according to the preoperative clinical examination (stress test). Thirty patients with patent (group A) stress urinary incontinence (SUI) and 15 patients with occult SUI (group B) had a MUS associated with sacrocolpopexy. Thirty-eight patients with negative stress test (group C) were treated by sacrocolpopexy without MUS, even if they had history of SUI. At each visit, urinary symptoms (UDI-6) and their impact on quality of life (UIQ-7) were evaluated using validated self-questionnaires, Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire.

RESULTS

After 3years of mean follow-up, SUI was improved in 22/30 (77%) of patients in group A and only one patient needed a second MUS. Dysuria was cured in 9/12 (75%), 5/7 (71%) and 16/19 (84%) of patients of groups A, B, C respectively and urge urinary incontinence in 13/19 (68%), 2/2 (100%) and 4/6 (67%) of patients. The rate of de novo urge incontinence was respectively 1/11 (9%), 2/13 (15%) and 6/32 (19%). De novo SUI appeared in 6/32 (19%) of patients in group C, but only 2 of them secondarily needed a MUS. After 3 years, our study showed a significant decrease of UDI-6 of 62, 63 and 48% comparing with preoperative score and of UIQ-7 of 77, 54 and 81%.

CONCLUSION

Laparoscopic sacrocolpopexy associated with MUS for patent stress urinary incontinence improves significantly stress and urgency urinary incontinence. Laparoscopic sacrocolpopexy without MUS, when physical exam shows a negative stress test, significantly reduces voiding difficulties with very few cases of de novo stress and urge incontinence.

LEVEL OF EVIDENCE

4.

Authors+Show Affiliations

Service de gynécologie-obstétrique, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France. Electronic address: salerno_jennifer@hotmail.com.Service de gynécologie-obstétrique, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France.Service d'urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France.Service d'urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France.Service d'urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France.Service de gynécologie-obstétrique, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France.Service d'urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

27068055

Citation

Salerno, J, et al. "[Impact of Laparoscopic Sacrocolpopexy, With or Without a Midurethral Sling, On Lower Urinary Tract Symptoms]." Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, vol. 26, no. 7, 2016, pp. 401-8.
Salerno J, de Tayrac R, Droupy S, et al. [Impact of laparoscopic sacrocolpopexy, with or without a midurethral sling, on lower urinary tract symptoms]. Prog Urol. 2016;26(7):401-8.
Salerno, J., de Tayrac, R., Droupy, S., Costa, P., Llinares, E., Fatton, B., & Wagner, L. (2016). [Impact of laparoscopic sacrocolpopexy, with or without a midurethral sling, on lower urinary tract symptoms]. Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, 26(7), 401-8. https://doi.org/10.1016/j.purol.2016.03.003
Salerno J, et al. [Impact of Laparoscopic Sacrocolpopexy, With or Without a Midurethral Sling, On Lower Urinary Tract Symptoms]. Prog Urol. 2016;26(7):401-8. PubMed PMID: 27068055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Impact of laparoscopic sacrocolpopexy, with or without a midurethral sling, on lower urinary tract symptoms]. AU - Salerno,J, AU - de Tayrac,R, AU - Droupy,S, AU - Costa,P, AU - Llinares,E, AU - Fatton,B, AU - Wagner,L, Y1 - 2016/04/05/ PY - 2015/05/17/received PY - 2016/03/08/revised PY - 2016/03/10/accepted PY - 2016/4/13/entrez PY - 2016/4/14/pubmed PY - 2017/5/4/medline KW - Bandelette sous-urétrale KW - Incontinence urinaire d’effort KW - Laparoscopic sacrocolpopexy KW - Pelvic organ prolapse KW - Prolapsus KW - Promonto-fixation cœlioscopique KW - Stress urinary incontinence KW - Suburethral sling SP - 401 EP - 8 JF - Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie JO - Prog. Urol. VL - 26 IS - 7 N2 - OBJECTIVE: To evaluate the impact of laparoscopic sacrocolpopexy, with or without simultaneous midurethral sling (MUS), on urinary symptoms and health-related quality of life of patients. MATERIALS: A prospective analysis was carried out including 83 women with symptomatic pelvic organ prolapse who had laparoscopic sacrocolpopexy between 2009 and 2011. Patients were classified according to the preoperative clinical examination (stress test). Thirty patients with patent (group A) stress urinary incontinence (SUI) and 15 patients with occult SUI (group B) had a MUS associated with sacrocolpopexy. Thirty-eight patients with negative stress test (group C) were treated by sacrocolpopexy without MUS, even if they had history of SUI. At each visit, urinary symptoms (UDI-6) and their impact on quality of life (UIQ-7) were evaluated using validated self-questionnaires, Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. RESULTS: After 3years of mean follow-up, SUI was improved in 22/30 (77%) of patients in group A and only one patient needed a second MUS. Dysuria was cured in 9/12 (75%), 5/7 (71%) and 16/19 (84%) of patients of groups A, B, C respectively and urge urinary incontinence in 13/19 (68%), 2/2 (100%) and 4/6 (67%) of patients. The rate of de novo urge incontinence was respectively 1/11 (9%), 2/13 (15%) and 6/32 (19%). De novo SUI appeared in 6/32 (19%) of patients in group C, but only 2 of them secondarily needed a MUS. After 3 years, our study showed a significant decrease of UDI-6 of 62, 63 and 48% comparing with preoperative score and of UIQ-7 of 77, 54 and 81%. CONCLUSION: Laparoscopic sacrocolpopexy associated with MUS for patent stress urinary incontinence improves significantly stress and urgency urinary incontinence. Laparoscopic sacrocolpopexy without MUS, when physical exam shows a negative stress test, significantly reduces voiding difficulties with very few cases of de novo stress and urge incontinence. LEVEL OF EVIDENCE: 4. SN - 1166-7087 UR - https://www.unboundmedicine.com/medline/citation/27068055/[Impact_of_laparoscopic_sacrocolpopexy_with_or_without_a_midurethral_sling_on_lower_urinary_tract_symptoms]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1166-7087(16)00076-2 DB - PRIME DP - Unbound Medicine ER -