De novo urinary incontinence and lower urinary tract symptoms after colpocleisis: A single-center prospective study

Abstract

BackgroundColpocleisis is one of traditional surgical procedures for elderly and frail women with advanced pelvic organ prolapse. The occurrence of de novo urinary incontinence following colpocleisis was considered to impair the postoperative quality of life. The incidence of de novo urinary incontinence after colpocleisis has been reported to be ranging from 6.6% to 27%. There was an absence of prospective large-sample study to investigate the accurate incidence of de novo urinary incontinence following colpocleisis and the impact on the quality of life till now. Purposes The primary objective was to report the incidence of de novo urinary incontinence after colpocleisis. The second objectives were to evaluate the long-term quality of life in patients with de novo urinary incontinence, and to conduct detailed pre- and post-operative evaluations of lower urinary tract symptoms. MethodsThis prospective study included 253 patients with symptomatic pelvic organ prolapse who underwent colpocleisis between 2009 and 2021. De novo urinary incontinence was defined as the occurrence of urinary incontinence 3 months postoperatively. All patients were required to complete the Urinary Distress Inventory questionnaire and the Urinary Impact Questionnaire for the evaluation of patients’ quality of life, and the Patient Global Impression of Improvement questionnaire for the evaluation of patients’ satisfaction. Results245 patients (245/253, 96·8%) completed the 3-month follow-up, and were included in the final analysis. The incidence of de novo urinary incontinence was 5.4% (10/185). There was no significant difference in the Urinary Distress Inventory -6 scores (22.50 vs. 10.30, P=0.276) or the subjective satisfaction rate (100% vs. 98.9%, P=0.250) between the patients with or without de novo urinary incontinence at the long-term follow-up. The incidence of voiding difficulty was significantly reduced after colpocleisis (27.8% vs. 0.0%, P<0.001). The patients’ quality of life indicated by Urinary Distress Inventory-6 and Urinary Impact Questionnaire-7 scores were significantly improved postoperatively (26.27 vs. 13.39, and 19.13 vs. 6.05, P<0.05). ConclusionThe incidence of de novo urinary incontinence after colpocleisis was very low. Patients’ quality of life, and low urinary tract symptoms were significantly improved after colpocleisis.