Pelvic organ prolapse in a cohort of women treated for stress urinary incontinence

Peggy Norton, Linda Brubaker, Charles W. Nager, Gary E. Lemack, Halina M. Zyczynski, Larry Sirls, Leslie Rickey, Anne Stoddard, R. Edward Varner

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4 Scopus citations

Abstract

STUDY DESIGN: We measured baseline prolapse symptoms and anatomic prolapse in subjects enrolled in the trial of midurethral sling (TOMUS) and E-TOMUS, and measured these same parameters annually for 5-7 years after the index surgery. Additional information about subsequent treatment for POP was also recorded.

RESULTS: In all, 597 women were randomized to 1 of 2 midurethral sling procedures in the TOMUS; concomitant vaginal procedures for POP were allowed at the surgeon's discretion. Stage 2 POP was present at baseline in 291 subjects (49%). Symptoms of POP were reported in 67 (25%). Of the asymptomatic women, 34 of 223 (15%) underwent a concomitant POP repair at the time of index sling surgery. Anatomic progression of prolapse in women with asymptomatic, unoperated stage 2 POP over the next 72 months was infrequent and occurred in only 3 of 189 subjects (2%); none underwent surgery for POP. Most symptomatic women (47/67 [70%]) underwent a concomitant repair for POP at the index sling surgery. Three of the 47 women who had undergone concomitant repair for symptomatic stage 2 POP underwent repeat POP surgery (2 at 36 months and 1 at 48 months.)

CONCLUSION: For patient populations similar to the TOMUS and E-TOMUS populations, surgeons may counsel women with asymptomatic stage 2 POP that their prolapse is unlikely to require surgery in the next 5-7 years.

OBJECTIVE: The aim of our study was to observe pelvic organ prolapse (POP) over time, treated and untreated, in a group of highly characterized women being followed up subjectively and objectively over 5-7 years following continence surgery.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume211
Issue number5
DOIs
StatePublished - Nov 1 2014

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Keywords

  • asymptomatic cystocele
  • midurethral sling
  • stress urinary incontinence
  • urogynecology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Norton, P., Brubaker, L., Nager, C. W., Lemack, G. E., Zyczynski, H. M., Sirls, L., Rickey, L., Stoddard, A., & Varner, R. E. (2014). Pelvic organ prolapse in a cohort of women treated for stress urinary incontinence. American Journal of Obstetrics and Gynecology, 211(5). https://doi.org/10.1016/j.ajog.2014.07.053