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

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

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. 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.

Original languageEnglish (US)
Pages (from-to)550.e1-550.e5
JournalAmerican journal of obstetrics and gynecology
Volume211
Issue number5
DOIs
StatePublished - Nov 1 2014

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    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), 550.e1-550.e5. https://doi.org/10.1016/j.ajog.2014.07.053