Transperineal Ultrasound Evaluation of Bladder Parameters in Patients with Apical Prolapse Undergoing Lateral Suspension or Sacropexy.

INTRODUCTION: and hypothesis.We evaluated different bladder parameters using Transperineal Ultrasound (TPUS) in patients with apical pelvic organ prolapse undergoing lateral suspension or sacropexy.

METHODS: We included 73 cases with 37 cases in lateral suspension (LS) group and 36 cases in sacropexy group. We enrolled cases with apical prolapse stage 2 or higher according to Pelvic Organ Prolapse Quantification system (POP-Q). Evaluation done of all cases using TPUS preoperatively and at 6, 12 and 18 months follow-up visits.

RESULTS: In LS group we found significant differences postoperatively in bladder neck height (Dy distance) at Valsalva and rest ( P value < 0.001 in both) and in β angle at Valsalva and rest ( P value < 0.001 in both). There was significant improvement in PVR ( P value < 0.001). In sacropexy group we found no significant differences postoperatively in bladder neck height at Valsalva ( P value 0.07) or in β angle at Valsalva ( P value 0.097). There was significant improvement in PVR ( P value 0.006). In between the 2 groups, there was better improvement in LS group than sacropexy group in bladder neck height at rest ( P value 0.001) and in β angle both at Valsalva and rest ( P value < 0.001 & 0.002 respectively). There was no significant difference in PVR, bladder wall thickness or bladder neck funnelling.

CONCLUSION: LS and sacropexy showed good postoperative improvement in some bladder parameters using TPUS with better improvement in bladder neck height in LS.

CLINICAL TRIAL REGISTRATION: Clinical trial ID: NCT03772691.