Byline: Maeve A. Serino, From the Feinberg School of Medicine and the Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois.; Sarah A. Collins; Kimberly Kenton; Julia Geynisman-Tan Abstract OBJECTIVES: To compare urethral length (UL), as measured by three-dimenstional transvaginal ultrasound, before and after minimally invasive sacrocolpopexy (SCP). METHODS: Secondary analysis of a prospective cohort study of women undergoing SCP for prolapse beyond the hymen with or without a concomitant anti-incontinence procedure. Participants underwent ultrasound at baseline and 14 weeks postoperatively. UL was measured in a reconstructed sagittal plane from the bladder neck to the urethral meatus. All of the participants underwent multichannel urodynamics preoperatively. Data were analyzed in SPSS using independent or paired t tests as indicated for continuous variables and the McNemar test for paired dichotomous variables. Correlations including nonparametric data are reported as Spearman rho. RESULTS: A total of 28 participants, with a mean Ø standard deviation age of 56 Ø 10 years and median (interquartile range) preoperative prolapse stage of 3 (3-3), were analyzed. There was no change in UL between the baseline and 14-week visits (29.8 Ø 11.0 mm vs 29.3 Ø 10.0 mm, P = 0.83). There was no difference in baseline UL (29.4 Ø 11.8 mm vs 30.9 Ø 8.9 mm, P = 0.74) in those with and without preoperative stress urinary incontinence (SUI), nor was there a difference in baseline functional UL on multichannel urodynamics between these groups. In total, 21 participants (75%) had preoperative SUI and 19 (90%) underwent a concomitant anti-incontinence procedure. UL at 14 weeks was similar in those with and without SUI symptoms (26.5 Ø 10.9 mm vs 31.1 Ø 11.3 mm, P = 0.32) when controlling for those who underwent anti-incontinence procedures. CONCLUSION: UL does not change following suspension of the anterior vaginal wall with SCP.