LOWER URINARY TRACT SYMPTOMSASSESSMENT BEFORE AND AFTER LAPAROSCOPIC SACROCOLPOPEXY
C. KATO1, T. KUWATA2, M. TAKEYAMA 3;
1First TowakaiHosp., takatuki city, Japan, 2First Towa Hosp., Takatsuki,Japan, 3First Towakai Hosp., Takatsuki city, Japan.
Introduction: Laparoscopicsacrocolpopexy (LSC) has been a gold standard procedure for pelvicorgan prolapse (POP). Since the Japanese public insurance began tocover this procedure two years ago, the number of hospitals startingto perform this operation has rapidly increased. However the reporteddata on the anatomic and functional outcome after LSC islimited.
Objective: In this study, we focused on lowerurinary tract symptoms (LUTS) before and after LSC.
Methods:Patients: One hundred seventy eight patients underwent LSC betweenMarch 7th 2013 and April 30th 2016. Patients characteristics:Median(range) of patient’s age was 63 (43-77), mean±SD of BMI was22.0±2.0. Most descending part : anterior 111, middle 56,andposterior 4 Hysterectomy had been performed in 9 cases. LSC wereconducted according to Watties’s methods. Uterus was preserved in21 cases. Subtotal hysterectomy was performed in 141 cases. (uterinepreservation in 21 cases. subtotal hysterectomy in 141 cases).Anatomical outcome was assessed with POP-Q. LUTS assessment was madebefore and 1,3,6,12,18 and 24months after LSC with OABSS, IPSS andICIQ-SF. Uroflowmetry before and after LSC was alsoassessed.
Results: Operating time was 206±62min. Amount ofbleeding was 30±57.3gr. Residual urine volume more than 100ml wereobserved in 10 cases, but disappeared within a weak in all cases.Qmax (20.6 and 23.3) and Qave (11.1 and 13.3) of uroflwmetory weresignificantly improved between before and 6 months after LSC. Thereis no significant difference in total score of OABSS(3.2 and 2.6). Intotal score of IPSS (8.4 and 3.6) and IPSS QOL (4.3 and 1.7) weresignificantly lower than before. In total score(3.3) and QOLscore(1.5) of ICIQ-SF after LSC were significantly lower than thosebefore LSC(6.8 and 4.0 respectively). TVT procedures were needed in17 cases after LSC.
Conclusions: Although Voiding symptomsimproved and OAB symptoms did not change after LSC , stress urinaryincontinence remained or become excerbated. So LSC had an influenceon the LUTS symptoms. Further accumulation of data is necessary toexamine the results of LSC in detail.
Table1 Summary of operation
Insertionsite of mesh