1.The Presence of Preoperative Urinary Incontinence Significantly Correlates With Postoperative Urinary Incontinence Following Laparoscopic Sacrocolpopexy
Kenji KURODA ; Koetsu HAMAMOTO ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2025;29(1):27-33
Purpose:
Urinary incontinence (UI) is a significant complication following surgery for pelvic organ prolapse (POP), including laparoscopic sacrocolpopexy (LSC). Although the incidence of postoperative UI is lower after LSC than after transvaginal mesh surgery, a subset of patients still experience UI. This study aimed to determine which factors, including mesh-related factors, contribute to UI impairing daily life following LSC.
Methods:
The study enrolled 96 patients who underwent LSC at our institution between June 2016 and September 2023. The Pearson chi-square test, multiple logistic regression analysis, and Cox proportional hazards model were used to determine the independent factors contributing to UI after LSC.
Results:
The Pearson chi-square test showed that body mass index, POP quantification (POP-Q) stage 4 and the presence of preoperative UI significantly correlated with the postoperative UI among preoperative and intraoperative factors (all P<0.05). POP-Q stage 4 and the presence of preoperative UI were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (all P<0.05). However, only preoperative UI remained an independent predictor for shorter time to UI onset in the multivariate Cox proportional hazards model (hazard ratio, 3.56; 95% confidence interval, 1.29–11.58; P=0.0158).
Conclusions
Patients with preoperative UI and stage 4 POP should receive close monitoring for postoperative UI.
2.The Presence of Preoperative Urinary Incontinence Significantly Correlates With Postoperative Urinary Incontinence Following Laparoscopic Sacrocolpopexy
Kenji KURODA ; Koetsu HAMAMOTO ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2025;29(1):27-33
Purpose:
Urinary incontinence (UI) is a significant complication following surgery for pelvic organ prolapse (POP), including laparoscopic sacrocolpopexy (LSC). Although the incidence of postoperative UI is lower after LSC than after transvaginal mesh surgery, a subset of patients still experience UI. This study aimed to determine which factors, including mesh-related factors, contribute to UI impairing daily life following LSC.
Methods:
The study enrolled 96 patients who underwent LSC at our institution between June 2016 and September 2023. The Pearson chi-square test, multiple logistic regression analysis, and Cox proportional hazards model were used to determine the independent factors contributing to UI after LSC.
Results:
The Pearson chi-square test showed that body mass index, POP quantification (POP-Q) stage 4 and the presence of preoperative UI significantly correlated with the postoperative UI among preoperative and intraoperative factors (all P<0.05). POP-Q stage 4 and the presence of preoperative UI were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (all P<0.05). However, only preoperative UI remained an independent predictor for shorter time to UI onset in the multivariate Cox proportional hazards model (hazard ratio, 3.56; 95% confidence interval, 1.29–11.58; P=0.0158).
Conclusions
Patients with preoperative UI and stage 4 POP should receive close monitoring for postoperative UI.
3.The Presence of Preoperative Urinary Incontinence Significantly Correlates With Postoperative Urinary Incontinence Following Laparoscopic Sacrocolpopexy
Kenji KURODA ; Koetsu HAMAMOTO ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2025;29(1):27-33
Purpose:
Urinary incontinence (UI) is a significant complication following surgery for pelvic organ prolapse (POP), including laparoscopic sacrocolpopexy (LSC). Although the incidence of postoperative UI is lower after LSC than after transvaginal mesh surgery, a subset of patients still experience UI. This study aimed to determine which factors, including mesh-related factors, contribute to UI impairing daily life following LSC.
Methods:
The study enrolled 96 patients who underwent LSC at our institution between June 2016 and September 2023. The Pearson chi-square test, multiple logistic regression analysis, and Cox proportional hazards model were used to determine the independent factors contributing to UI after LSC.
Results:
The Pearson chi-square test showed that body mass index, POP quantification (POP-Q) stage 4 and the presence of preoperative UI significantly correlated with the postoperative UI among preoperative and intraoperative factors (all P<0.05). POP-Q stage 4 and the presence of preoperative UI were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (all P<0.05). However, only preoperative UI remained an independent predictor for shorter time to UI onset in the multivariate Cox proportional hazards model (hazard ratio, 3.56; 95% confidence interval, 1.29–11.58; P=0.0158).
Conclusions
Patients with preoperative UI and stage 4 POP should receive close monitoring for postoperative UI.
4.The International Consultation on Incontinence Questionnaire Short Form as a Substitute for 1-Hour Pad Weight Testing in the Evaluation of Urinary Incontinence in Patients With Pelvic Organ Prolapse Undergoing Surgery
Kenji KURODA ; Koetsu HAMAMOTO ; Kazuki KAWAMURA ; Ayako MASUNAGA ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2024;28(3):215-224
Purpose:
Stress urinary incontinence is a postoperative complication occurring in patients with pelvic organ prolapse (POP). Although the 1-hour pad test measures the degree of urinary incontinence qualitatively and quantitatively, some elderly women undergoing POP surgery do not have the daily activities of living to perform the pad test. Therefore, we examined whether the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) could be used as an alternative tool for pad tests.
Methods:
We retrospectively evaluated 132 patients with POP. In our hospital, 57 patients were treated by laparoscopic sacrocolpopexy (LSC), whereas 75 were treated by transvaginal mesh surgery (TVM). We measured the changes in symptoms preand postoperatively using the ICIQ-SF and 1-hour pad weight testing, and investigated the correlation between the total plus component question scores of the ICIQ-SF and 1-hour pad weight.
Results:
The preoperative ICIQ total scores in all patients decreased significantly as the amount of leakage on the 1-hour pad weight decreased. The component question scores also decreased significantly with decreasing levels of 1-hour pad weight. The LSC and TVM groups had decreased ICIQ-SF total and component question scores as pad weight decreased. At 12 months postoperatively, the ICIQ total scores in all patients significantly declined as the amount of leakage on the 1-hour pad weight decreased. In the LSC group, the ICIQ-SF total and component question scores also decreased with decreased pad weight, but the differences were not always significant between ICIQ scores and pad weight. In the TVM group, the ICIQ-SF total and component question scores also significantly decreased as the pad weight decreased.
Conclusions
The ICIQ-SF could be an appropriate substitute for the 1-hour pad weight testing in predicting the severity of urinary incontinence. In the future, we hope to predict the level of urine leakage based on the ICIQ-SF score.