Voiding function after pelvic reconstructive surgery in patients with pelvic organ prolapse at Alzahra and Taleghani hospitals in 1401-02

Abstract

In this study, we aimed to investigate the impact of reconstructive surgery on urinary symptoms and voiding function in patients with pelvic organ prolapse. Method: We designed a multicenter prospective study on patients with POP in two Hospitals. Inclusion criteria were defined as follows: 1) all patients with ≥ stage 2 prolapse based on the Pelvic Organ Prolapse Quantification system (POP-Q). Exclusion criteria were: 1) patients with neurogenic bladder. The voiding function of patients was evaluated based on the Pelvic Floor Disability Index-20 (PFDI-20) and uroflowmetry test. All included participants underwent surgery by one Urogynecologist using the sacrospinous ligament suspension (SSLS) method. Anterior and posterior compartment repair was done where indicated. Patients with objective stress urinary incontinence (SUI) in the urodynamic study underwent TOT surgery. All statistical analyses were conducted using IBM SPSS statistic 26. Results: 118 patients were included in the study. The mean age of participants was 52.74 ± 11.95 years and the mean BMI was 27.34 ± 4.18 Kg/m2. 21.2% of participants underwent trans-obturator tape (TOT) surgery. Three subgroups of PFDI-20 (prolapse, colorectal, and urinary symptoms) had obvious improvement after surgery (p<0.001). Lower urinary tract symptoms including stress urinary incontinence, frequency, urgency, post-void dribbling, and incomplete emptying significantly improved after SSLS surgery (p<0.001). Furthermore, there was a lower rate of hesitancy among patients included post-surgery (p= 0.031). Post-void residual volume (PVR) had a statistically significant improvement (p=0.043). There is not any report of adverse events of SSLS surgery in follow-up visits.