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

Authors: Norton, P.; Brubaker, L; Nager, C. W.; Lemack, G. E.; Zyczynski, H. M.; Sirls, L; Rickey, L; Stoddard, A; Varner, R. E.; Urinary Incontinence Treatment Network
Article Title: Pelvic organ prolapse in a cohort of women treated for stress urinary incontinence
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 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 Mid Urethral slings (TOMUS) and E-TOMUS trials, and measured these same parameters annually for five to seven years after the index surgery. Additional information about subsequent treatment for POP was also recorded. RESULTS: 597 women were randomized to one of two mid-urethral sling procedures in the TOMUS trial; concomitant vaginal procedures for POP were allowed at the surgeon's discretion. Stage 2 POP was present at baseline in 291 of subjects (49%). Symptoms of POP were reported in 67 (25%). Of the asymptomatic women, 34/223 (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 3/189 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.
Journal Title: American Journal of Obstetrics and Gynecology
Volume: 211
Issue: 5
ISSN: 1097-6868; 0002-9378
Publisher: Unknown  
Date Published: 2014
Start Page: 550.e1-5
Language: ENG
Notes: CI: Copyright (c) 2014; JID: 0370476; OTO: NOTNLM; 2014/01/03 [received]; 2014/05/30 [revised]; 2014/07/30 [accepted]; aheadofprint