Introduction and hypothesis The aim of this study was to determine the reoperation rate for sling placement or revision in patients who had primary continence procedures based on prolapse reduction stress testing (RST) prior to laparoscopic sacral colpoperineopexy (LSCP). Methods This was a retrospective cohort study of women who had RST prior to LSCP for symptomatic pelvic organ prolapse. Patients with positive test (Pos RST) had a concomitant midurethral sling procedure and those with negative test (Neg RST) did not. Variables were compared with either Student’s t test or Fisher’s exact test. Results In Neg RST group ( n  = 70), the rate of surgery for de novo urodynamic stress incontinence was 18.6%. In Pos RST group ( n  = 82), the rate of sling revision for bladder outlet obstruction was 7.3%. Overall, 88% of patients did not require a second surgery. Conclusions The use of RST to recommend concomitant continence procedures during LSCP results in a single surgery for the majority of our patients.