Should we perform multichannel urodynamics for the decision of concomitant urinary incontinence surgery to abdominal sacrocolpopexy?

Aim: The aim of this study was to evaluate the outcomes of concomitant Burch colposuspension (BC) according to the presence of urodynamically proven stress urinary incontinence (USUI) in patients decided for abdominal sacrocolpopexy (ASC) and whether there is a proxy to predict USUI instead of urodynamics. Material and Method: The records of patients who performed ASC between January 2009 and December 2022 were retrospectively evaluated. According to the presence of USUI in preoperative multichannel urodynamics, two main groups were formed as those with and without concomittant BC. Preoperative, perioperative and postoperative data were compared in groups and then independent variables that could predict the presence of USUI in the whole cohort were determined. Results: In 53 (48.6%) of 109 patients who underwent ASC surgery, preoperative USUI was detected and concomitant BC was performed. In 56 (51.4%) patients, no USUI was detected and only ASC was performed. SUI, provovative stresss test (PST) positivity, overactive bladder symptoms, symptom questionnaire form scores decreased in both groups postoperatively. Multivariable logistic regression analysis was performed to determine the parameters that could predict the USUI in the whole cohort. Office-based PST with reduction was the strongest independent variable predicting USUI. Conclusion: BC concomitantly with ASC is an effective and safe method in the group of patients with USUI detected on multichannel urodynamic examination performed with prolapse reduction. Office-based PST with reduction was determined as an independent variable that can predict USUI. Therefore, it may be useful in the decision to add urinary incontinence surgery to POP surgery.