Fix Pelvic Organ Prolapse but Skip Prophylactic Incontinence Procedure: Study

May 13, 2011

NEW YORK (Reuters Health) May 11 - When continent women have pelvic organ prolapse repair, there's no point to adding a Burch colposuspension (BC) to prevent incontinence, according to researchers who looked at long-term data from a randomized trial.

"Despite the lack of evidence that pelvic organ prolapse repair and postoperative ex novo stress urinary incontinence are linked, urologists and gynecologists have long performed (the repair) with an anti-incontinence procedure...as a prophylactic measure in continent women," said Dr. Massimo Lazzeri and colleagues at the University of Perugia in a report of the study.

Between 2000 and 2004, the researchers randomly assigned 66 continent women undergoing pelvic organ prolapse repair to have the operation done with or without concomitant BC.

After a median follow-up of more than eight years, nine women in the BC group (29%) were incontinent, compared to five (16%) in the control group. The difference was not significant, the research team reported online April 18th in the Journal of Urology.

The difference was more dramatic when the average follow-up was just over three years -- 26.5% vs. 3.1% -- showing, the authors say, that the "the continence rate tended to worsen when follow up was extended."

The results are not completely dependable, however. Six women in the group without BC had undergone prior incontinence surgery, which could have increased the continence rate in this group.

Still, the researchers conclude, "Our long-term follow-up results cast doubt on whether BC should be done during pelvic organ repair in continent women. Further studies remain mandatory to confirm our results and investigate alternative anti-incontinence procedures."

SOURCE: https://bit.ly/koG5ec

J Urol 2011.

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