Introduction and Hypothesis <p>Direct comparison of lower urinary tract symptoms (LUTS) such as overactive bladder (OAB) and stress urinary incontinence (SUI) before and after laparoscopic sacrocolpopexy (LSC) and robot-assisted sacrocolpopexy (RSC) for pelvic organ prolapse (POP) is not reported enough. We investigated the prevalence of OAB and SUI before and after LSC and RSC, comparing the effects of these surgical methods on LUTS.</p> Methods <p>A retrospective analysis was performed for patients who underwent LSC or RSC for POP (294 LSC and 104 RSC cases) at a single general hospital in Japan from 2022 to 2023. Preoperative and 6-month postoperative OAB and SUI prevalences were determined based on the OAB symptom scores and International Consultation on Incontinence Questionnaire-Short Form. Changes in the prevalence of OAB and SUI before and after surgery were examined within and between the RSC and LSC groups.</p> Results <p>The prevalence of OAB in the RSC group decreased significantly from 43.9% (<i>n</i> = 43) preoperatively to 26.5% (<i>n</i> = 26) postoperatively, and in the LSC group from 43.6% (<i>n</i> = 119) to 24.9% (<i>n</i> = 68), with no significant difference in the proportion of de novo OAB between the groups. The prevalence of SUI in the RSC group increased significantly from 36.4% (<i>n</i> = 36) preoperatively to 58.6% (<i>n</i> = 58) postoperatively, and in the LSC group from 54.0% (<i>n</i> = 148) to 62.0% (<i>n</i> = 170) postoperatively, with no significant difference in the proportion of de novo SUI.</p> Conclusions <p>Both RSC and LSC for POP may improve symptoms in patients with pre-OAB and induce de novo SUI, with no significant difference between the groups.</p>