Urinary Outcomes Following a Novel Reconstructive Pelvic Organ Prolapse Surgery: Randomized Controlled Trial

Background and Objectives: The close anatomical relationship between pelvic support structures and the lower urinary tract contributes to high rates of urinary dysfunction among patients with pelvic organ prolapse (POP). POP reduction alone has been shown to alter urinary tract functioning. The aim of this study was to assess urinary functioning outcomes following a novel reconstructive surgical technique for POP. Materials and Methods: This randomized controlled trial was conducted between September 2024 and December 2025. The trial was registered in the German Clinical Trials Register (identifier: DRKS00038206), on 27 October 2025. Participants were randomly assigned to undergo either conventional laparoscopic sacrocervicopexy or the modified technique. Urinary outcomes were assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI), the Urogenital Distress Inventory Short Form (UDI-6), the cough test, and urodynamic testing. Assessments were performed prior to surgery and at a 6-month follow-up. Results: Both the classical and modified techniques resulted in significant improvements in ICIQ-UI and UDI-6 scores. However, no statistically significant differences were observed between groups. De novo SUI occurred in 14.3% of patients in the classical technique group and in no patients in the modified technique group. Conclusions: Urinary symptoms improved in both groups, with no statistically significant between-group differences. De novo SUI occurred only in the classical technique group, but this finding should be interpreted cautiously given the limited sample size. These results are exploratory and hypothesis-generating, and larger studies with longer follow-up are needed to clarify whether true between-group differences in postoperative continence outcomes exist.