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Introduction and Hypothesis <p>To explore whether concurrent midurethral sling surgery (MUS) is necessary for pelvic organ prolapse (POP) patients with simple anatomical stress urinary incontinence (SUI) undergoing laparoscopic lateral abdominal wall suspension (LLS).</p> Methods <p>A multicenter prospective cohort study enrolled 200 eligible patients (stage Ⅱ + apical/anterior POP with SUI) from 2022–2024, divided into LLS + MUS (n = 100) and LLS alone (n = 100), with 40 healthy controls. Outcomes included urodynamic tests, ISI, POP-Q, MRI, and PGI-I at baseline, 3&#xa0;months, and 1&#xa0;year.</p> Results <p>170 patients (85%) completed 1-year follow-up. LLS + MUS group had higher SUI cure rate (85.3% vs 50.9%, <i>P</i> &lt; 0.05) but more complications (urinary tract infection:17.6% vs 5.9%; urinary retention:8.8% vs 0%; dyspareunia:35.3% vs 15.7%; mesh exposure:14.7% vs 2%, all <i>P</i> &lt; 0.05). LLS alone group showed higher satisfaction (86.3% vs 67.6%, <i>P</i> &lt; 0.05). POP anatomical reduction rates were similar between groups (<i>P</i> &gt; 0.05).</p> Conclusions <p>For apical/anterior POP with SUI, LLS alone is preferred, with delayed MUS if needed, reducing complications and improving satisfaction.</p>

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Strategy of Delayed Midurethral Sling Surgery for Pelvic Organ Prolapse with Stress Urinary Incontinence after Laparoscopic Lateral Abdominal Wall Suspension

  • 期刊论文

  • 发表日期：

    2025年12月11日

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  • Jie Yu,
  • Xinyue Wang,
  • Huajie Wu,
  • Xuejiang Ji,
  • Chenyan Jia,
  • Sigui Feng,
  • Mo Shen,
  • Rui Chen,
  • Qinjun Ge

摘要

Introduction and Hypothesis

To explore whether concurrent midurethral sling surgery (MUS) is necessary for pelvic organ prolapse (POP) patients with simple anatomical stress urinary incontinence (SUI) undergoing laparoscopic lateral abdominal wall suspension (LLS).

Methods

A multicenter prospective cohort study enrolled 200 eligible patients (stage Ⅱ + apical/anterior POP with SUI) from 2022–2024, divided into LLS + MUS (n = 100) and LLS alone (n = 100), with 40 healthy controls. Outcomes included urodynamic tests, ISI, POP-Q, MRI, and PGI-I at baseline, 3 months, and 1 year.

Results

170 patients (85%) completed 1-year follow-up. LLS + MUS group had higher SUI cure rate (85.3% vs 50.9%, P < 0.05) but more complications (urinary tract infection:17.6% vs 5.9%; urinary retention:8.8% vs 0%; dyspareunia:35.3% vs 15.7%; mesh exposure:14.7% vs 2%, all P < 0.05). LLS alone group showed higher satisfaction (86.3% vs 67.6%, P < 0.05). POP anatomical reduction rates were similar between groups (P > 0.05).

Conclusions

For apical/anterior POP with SUI, LLS alone is preferred, with delayed MUS if needed, reducing complications and improving satisfaction.