Prospective longitudinal study of long-term voiding outcomes after laparoscopic sacrocolpopexy for pelvic organ prolapse

In this prospective follow-up longitudinal study, we investigated the long-term impact of laparoscopic sacrocolpopexy (SCP) on voiding dysfunction present prior to surgery in women with symptomatic pelvic organ prolapse (POP). Women from a previously published study who underwent SCP for symptomatic POP with objective and/or subjective voiding dysfunction between 01/2019 and 08/2021 were contacted and invited to attend an additional long-term follow-up visit for a clinical re-evaluation identical to the preoperative and postoperative visit (6–12 weeks). The postoperative outcome was assessed using uroflowmetry, the POP-Q quantification system and the validated German version of the Australian Pelvic Floor Questionnaire. Forty-nine of the 84 women seen at the mid-term follow-up returned for a long-term visit, with a mean follow-up period of 20.3 ± 6.5 months. A significant (p < 0.001) objective improvement in POP correction was seen (for Ba, C and Bp) at the long-term visit. A significant (p < 0.001) overall decrease in median postvoid residual volume was achieved (preoperative: 90 ml, mid-term: 10 ml, long-term: 15 ml). Furthermore, the maximal flow rate significantly (p = 0.003) increased and there was a decrease in voiding time (p = 0.048), with no significant difference found between mid- and long-term assessments. Similarly, subjective parameters improved significantly, concerning prolonged urine stream, sensation of incomplete bladder emptying and straining to void (all p values < 0.001). In the same way, a significant improvement was observed in subjective reports regarding overactive bladder symptoms and POP complaints (all p values < 0.001), with no change between mid- and long-term analysis, while no change was noted in dyspareunia over time. Laparoscopic SCP performed for symptomatic POP provides durable anatomical correction and is associated with significant mid- and long-term improvements in both objective voiding function and patient-reported symptoms. In this study, women who underwent surgery (laparoscopic sacrocolpopexy) for symptomatic pelvic organ prolapse and voiding difficulties were re-evaluated at a follow-up visit to assess the long-term effects of the surgical correction on micturition function. Mean follow-up was 20 months after surgery and was identical to the preoperative and postoperative (mid-term) evaluations and included tests of bladder emptying, a physical examination and a symptom questionnaire. The results showed that the surgery gave lasting anatomical support and led to clear improvements in both bladder function and symptoms. These improvements were the same at the mid-term and long-term follow-ups, showing that the benefits of the surgery were stable and long-lasting.