Journal of minimally invasive gynecology · 2025
Does Concurrent Burch Colposuspension Reduce Postoperative Stress Urinary Incontinence in Laparoscopic Sacrocolpopexy? An Interim Analysis.
СтатьяНазвание и аннотация: Перевод в очереди
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Oyama Keisuke, Ikeda Shoko, Yuda Makiko
Аннотация
STUDY OBJECTIVE: This study aimed to evaluate whether performing Burch colposuspension (BC) concurrently with laparoscopic sacrocolpopexy (LSC) reduces the incidence of postoperative de novo stress urinary incontinence (SUI) and other urinary dysfunctions in patients with pelvic organ prolapse (POP).
DESIGN: A prospective cohort study conducted at a single center.
SETTING: The study was performed at a regional hospital specializing in gynecologic surgery.
PATIENTS: Twenty patients with ≥stage II POP scheduled for LSC (July 2023-June 2024), without prior prolapse/incontinence treatment, were included regardless of preoperative urinary incontinence status. Patients chose their preferred procedure after comprehensive counseling on risks and benefits; randomization was not performed.
INTERVENTIONS: The LSC group underwent LSC alone, while the LSC+BC group received BC concurrently with LSC. Subjective symptoms were assessed using standardized questionnaires, including the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the King's Health Questionnaire (KHQ), as well as a cough stress test, preoperatively and at 3 months postoperatively.
MEASUREMENTS AND MAIN RESULTS: Interim analysis showed a median [interquartile range] ICIQ-SF change of -3 [-6, 0] in the LSC group versus 0 [-5, 3] in the LSC+BC group (p = .360). The KHQ Incontinence Impact scale changed by -17 [-33, 25] for LSC versus 0 [-33, 0] for LSC+BC (p = 1.000), and severity scores were -17 [-32, 5] versus 0 [-5, 22] (p = .305). Although LSC tended to yield better scores, the differences were not statistically significant. The median operative time was prolonged 52 minutes in the LSC+BC group (p < .001), and 1 bladder injury occurred in this group.
CONCLUSION: This preliminary study suggests that adding BC to LSC did not significantly improve postoperative de novo SUI but increased operative time and complication risks. These findings suggest that routine use of BC in minimally invasive sacrocolpopexy may not be beneficial.
DESIGN: A prospective cohort study conducted at a single center.
SETTING: The study was performed at a regional hospital specializing in gynecologic surgery.
PATIENTS: Twenty patients with ≥stage II POP scheduled for LSC (July 2023-June 2024), without prior prolapse/incontinence treatment, were included regardless of preoperative urinary incontinence status. Patients chose their preferred procedure after comprehensive counseling on risks and benefits; randomization was not performed.
INTERVENTIONS: The LSC group underwent LSC alone, while the LSC+BC group received BC concurrently with LSC. Subjective symptoms were assessed using standardized questionnaires, including the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the King's Health Questionnaire (KHQ), as well as a cough stress test, preoperatively and at 3 months postoperatively.
MEASUREMENTS AND MAIN RESULTS: Interim analysis showed a median [interquartile range] ICIQ-SF change of -3 [-6, 0] in the LSC group versus 0 [-5, 3] in the LSC+BC group (p = .360). The KHQ Incontinence Impact scale changed by -17 [-33, 25] for LSC versus 0 [-33, 0] for LSC+BC (p = 1.000), and severity scores were -17 [-32, 5] versus 0 [-5, 22] (p = .305). Although LSC tended to yield better scores, the differences were not statistically significant. The median operative time was prolonged 52 minutes in the LSC+BC group (p < .001), and 1 bladder injury occurred in this group.
CONCLUSION: This preliminary study suggests that adding BC to LSC did not significantly improve postoperative de novo SUI but increased operative time and complication risks. These findings suggest that routine use of BC in minimally invasive sacrocolpopexy may not be beneficial.