Dear Editor,
LeClaire et al. [1] reported an overall de novo stress incontinence rate of 15.9 % in their retrospective cohort study of 44 patients after laparoscopic or robot-assisted sacrocolpopexy. A greater reduction in point Aa was found to be a risk factor. We performed a prospective cohort study in 42 patients using both validated questionnaires and urodynamic evaluation before and after laparoscopic sacrocolpopexy with bone anchor fixation of the mesh to the 2nd or 3rd sacral segment [2]. The polypropylene mesh was sutured to the posterior vaginal wall. De novo stress incontinence was diagnosed in 7.5 % of the patients. A drawback of our operative method was the high failure rate for the anterior compartment, necessitating anterior colporrhaphy in 6 patients at a later time. These findings confirm the conclusion of LeClaire et al. on surgical approach and emphasize that prolapse of the anterior compartment should be corrected with caution.
References
LeClaire EL, Mukati MS, Juarez D, White D, Quiroz LH (2014) Is de novo stress incontinence after sacrocolpopexy related to anatomical changes and surgical approach? Int Urogynecol J 25:1201–1206. doi:10.1007/s00192-014-2366-1
Kummeling MTM, Rietbergen JBW, Withagen MIJ, Mannaerts GHH, Van der Weiden RMF (2013) Sequential urodynamic assessment before and after laparoscopic sacrocolpopexy. Acta Obstet Gynecol Scand 92:172–177
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van der Weiden, R.M.F., Withagen, M.I.J. Comments on LeClaire et al.: Is de novo stress incontinence after sacrocolpopexy related to anatomical changes and surgical approach?. Int Urogynecol J 26, 935 (2015). https://doi.org/10.1007/s00192-015-2657-1
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DOI: https://doi.org/10.1007/s00192-015-2657-1