Persistent and De Novo Stress Urinary Incontinence After Minimally Invasive Sacrocolpopexy

Abstract

Importance Data on stress urinary incontinence (SUI) after minimally invasive sacrocolpopexy (SCP) with or without midurethral sling placement are limited. Objective The aim of the study was to determine the incidence of SUI after minimally invasive sacrocolpopexy. Study Design This was a secondary analysis of 2 randomized clinical trials of participants undergoing SCP. Participants completed symptom assessment and urodynamic testing. Participants underwent SCP with or without midurethral sling placement. Preoperatively, participants were defined as having symptomatic SUI, occult SUI, or no SUI. Participants completed the Pelvic Floor Distress Inventory-20 at 6 and 12 months postoperatively and were categorized as having persistent SUI in the setting of symptomatic or occult SUI or de novo SUI. Results Eighty-one participants were included. Sixty-one participants met inclusion criteria for the persistent SUI analysis: 42 participants with symptomatic SUI and 19 participants with occult SUI. There were 20 participants in the de novo SUI group. The overall incidence of persistent SUI was 26.2% (95% confidence interval [CI], 15.8%–39.1%) with 33.3% (95% CI, 19.6%–49.6%) of symptomatic and 10.5% (95% CI, 1.5%–33.1%) of occult participants. Bothersome symptoms were defined as “moderately” or “quite a bit” bothered postoperatively. Of participants with symptomatic SUI, 14.3% participants were bothered and no participants underwent retreatment. No patient with occult SUI was bothered; however, 1 patient underwent retreatment. The incidence of de novo SUI was 45% (95% CI, 23.1%–68.5%). No patient in the de novo SUI group was bothered or underwent SUI treatment. Conclusions Approximately 1 in 4 participants reported persistent SUI. Almost 50% reported de novo SUI. However, few participants were bothered or underwent treatment.