E-Posters-The Predictive Value of Urodynamics in Women Undergoing Laparoscopic Mesh Sacrohysteropexy

The Predictive Value of Urodynamics in Women Undergoing Laparoscopic Mesh Sacrohysteropexy - Matthew L. Izett, BM BS, MRCOG

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This poster presents a retrospective case series that aims to determine if preoperative urodynamic studies (UDS) can predict postoperative bladder symptoms in women undergoing laparoscopic mesh sacrohysteropexy (LSH) for pelvic organ prolapse (POP). The study included 70 cases and analyzed demographic data and preoperative UDS diagnoses. The findings show that normal UDS were associated with a 15% risk of postoperative overactive bladder (OAB) and a 38% risk of stress urinary incontinence (SUI). Preoperative detrusor overactivity (DO) was predictive of postoperative OAB. Undertaking a concurrent continence procedure in the presence of preoperative urodynamic stress incontinence (USI) increased the likelihood of a favorable patient global impression of improvement (PGI-I) and reduced the likelihood of patient-reported SUI, although this was not statistically significant. There was no significant difference in bladder patient-reported outcome measure scores in any of the groups. The authors suggest that UDS may guide patient counseling prior to LSH, reassuring women with normal UDS about the low risk of postoperative OAB and counseling women with DO about the likelihood of persistent postoperative OAB symptoms. They also found that concurrent continence procedures in the presence of USI improved the patient impression of improved incontinence. However, the study is limited by small numbers and retrospective data, and further prospective work is needed to determine the diagnostic value and impact on quality of life. Overall, this study suggests that preoperative UDS can provide valuable information for predicting and managing postoperative bladder symptoms in women undergoing LSH for POP.

Keywords

urodynamic studies

preoperative

laparoscopic mesh sacrohysteropexy

pelvic organ prolapse

bladder symptoms

postoperative

overactive bladder

stress urinary incontinence

detrusor overactivity

urodynamic stress incontinence