Laparoscopic Colpopexy is it an Effective Intervention for Urinary Incontinence Associated with Female Pelvic Organ Prolapse?

Volume 3 - Issue 2

Walid Mohamed Elnagar*¹ and Ibrahem Ismail Samaha²

Received:May 12, 2019;   Published: May 22, 2019

DOI: 10.32474/IGWHC.2018.03.000159

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Abstract

Background: Pelvic organ prolapse is a distortion in normal anatomical correlations and integrity resulting in chronic distressing symptoms. Laparoscopic sacrocolpopexy is a frequently performed mesh-based surgical procedure for severe forms of pelvic organ prolapse having a high cure rate. Functional clinical outcomes evaluation after repair of pelvic prolapse is one of the cornerstone issues that determines the quality of health care service implemented.

Aim: To investigate and evaluate the functional clinical outcomes of conducting laparoscopic sacrocolpopexy by comparing and contrasting preoperative and postoperative urodynamic testing in cases clinically classified to have stages II to IV pelvic organ prolapse.

Methodology: A prospective research study conducted on 48 research study subjects from January 2016 till February 2018 undergoing laparoscopic sacrocolpopexy due to stage II–IV pelvic organ prolapse.

Results: urodynamic indices pre and post-operative in which as regards there was statistically significant difference regarding uroflowmetric indices, Qmax (maximum urinary flow), Elevated PVR (p value<0.001,0.001 consecutively ) as regards cystometric indices there was statistically significant difference between pre and post-operative findings concerning, low bladder compliance , involuntary detrusor contractions, detrusor muscle pressure, involuntary detrusor contractions, positive Valsalva (vesical) leakpoint pressure, (p values =0.016,0.001, <0.001 and 0.016 consecutively) although there was no statistical significant difference concerning maximum cystometric capacity, Abdominal VLPP positive(p value=0.098,0.617 consecutively. As regards pressure flow study indices there was statistical significant difference between pre and post-operative readings as regards Qmax, PVR, mean +/- SD Opening pressure , mean +/-SD Pdet Qmax (detrusor pressure at maximum flow), Median (IQR) of Time to maximum flow, Voiding time, Urogenital Distress Inventory, BOO bladder outlet obstruction, (p values<0.001 ,0.001) Whereas projected isovolumetric pressure <35 wasn’t statistically significant pre and post-operative (p value=0.063).

Conclusion and recommendations: Laparoscopic sacrocolopexy when properly performed on required cases results in marked improvement of most urodynamic indices. Future research efforts should be conducted in a multicentric manner to evaluate the effectiveness of this mode of management on long term. Keywords: Pelvic organ; Laparoscopic sacrocolpopexy; Urogynecological; Peritoneum

Keywords: Pelvic organ; Laparoscopic sacrocolpopexy; Urogynecological; Peritoneum

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