Incontinence and prolapse procedures found to be comparable in women

March 11, 2014

MAYWOOD - Two common procedures to treat pelvic organ prolapse without vaginal mesh are comparable in safety and efficacy, according to research published in the latest issue of the Journal of the American Medical Association. Researchers also found that behavioral and pelvic floor muscle therapy (BPMT) did not improve urinary incontinence or prolapse symptoms in affected women.

Pelvic organ prolapse occurs when the uterus and/or vaginal walls protrude outside of the body. Up to 73 percent of these women report other pelvic floor disorders such as incontinence. More then 300,000 surgeries are performed annually in the United States to correct pelvic organ prolapse. Two common prolapse procedures evaluated in this study included uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF).

"Little has been known until now about how these procedures compare to each other," said Linda Brubaker, MD, MS, study co-author and dean, Loyola University Chicago Stritch School of Medicine. "This study provides guidance to physicians on the benefits and risks of two widely used surgical interventions without vaginal prolapse mesh."

This study evaluated 374 women. A portion of the women underwent the ULS procedure (n = 188) while the other group had the SSLF surgery (n = 186). Success rates (59.2 percent versus 60.5 percent) and adverse events (16.5 percent versus 16.7 percent) were similar two years following the surgeries.

BPMT is an effective treatment for pelvic floor symptoms, which includes pelvic floor muscle training, individualized progressive pelvic floor muscle exercises and education on behavioral strategies to reduce incontinence. However, BPMT was not associated with greater improvements in incontinence symptoms at 6 months or prolapse at 2 years compared with usual care in study participants. Usual care included routine teaching and standardized postoperative instructions.
-end-
Other study authors included: Matthew D. Barber MD, Cleveland Clinic; Kathryn L. Burgio, PhD, University of Alabama at Birmingham and Department of Veterans Affairs; Holly E. Richter, PhD, MD, University of Alabama at Birmingham; Ingrid Nygaard, MD, University of Utah Medical Center; Alison C. Weidner, MD, Duke University Medical Center; Shawn A. Menefee, Southern California Kaiser Permanente; Emily S. Lukacz, MD, University of California-San Diego Health Systems; Peggy Norton, MD, University of Utah Medical Center; Joseph Schaffer, MD, University of Texas-Southwestern; John N. Nguyen, MD, Southern California Kaiser Permanente; Diane Borello-France PhD, Duquesne University; Patricia S. Goode, MD, University of Alabama at Birmingham and Department of Veterans Affairs; Sharon Jakus-Waldman, MD, Southern California Kaiser Permanente; Cathie Spino, ScD, University of Michigan; Lauren Klein Warren, MS, RTI International; Marie G. Gantz, PhD, RTI International; Susan F. Meikle, MD, Eunice Kennedy Shriver National Institute of Child Health and Human Development for the NICHD Pelvic Floor Disorders Network.

Loyola University Health System

Related Incontinence Articles from Brightsurf:

Higher risk of future fecal incontinence after sphincter injuries
The risk of subsequent fecal incontinence and intestinal gas leakage is significantly higher among women who, during childbirth, have suffered a sphincter injury and consequent damage to the anal sphincter muscle, was shown in a new study from the University of Gothenburg.

Kegels: Underused by women to treat and prevent urinary incontinence
Kegels are underused to treat and prevent urinary incontinence, especially during pregnancy and the postpartum period.

Magnetic stimulation dramatically improves fecal incontinence
Painless magnetic stimulation of nerves that regulate muscles in the anus and rectum appears to improve their function and dramatically reduce episodes of fecal incontinence, a debilitating problem affecting about 10% of the population, investigators report.

Does adding therapy before, after surgery for urinary incontinence help?
Adding behavioral and physical therapy before and after surgery for women with stress and urgency urinary incontinence resulted in a small improvement in symptoms compared to women who just had surgery but that difference in symptoms may not be clinically important.

Study shows advantages for stress urinary incontinence surgery
One of the most commonly performed surgeries to treat stress urinary incontinence in women may have better long-term results than another common surgical technique, according to a study led by Mayo Clinic researchers.

Childbirth delivery methods and risk of incontinence, overactive bladder
Pelvic floor disorders such as urinary incontinence and pelvic organ prolapse (when one or more of theĀ pelvic organsĀ drop from their normal position) are associated with childbirth and affect millions of women in the United States.

Poll: Half of women over 50 experience incontinence, but most haven't talked to a doctor
Nearly half of women over 50 say they sometimes leak urine according to a new national poll.

Getting relief from sexual dysfunction and incontinence caused by menopause
Microablative fractional CO2 lasers are energy-based devices designed to help manage troublesome menopause symptoms such as painful sex, dryness, itching/burning, urinary frequency, and incontinence.

Overweight and obesity linked to higher risk of urinary incontinence for women
Being overweight or obese is linked with an increased risk of developing urinary incontinence for young to mid-aged women, according to an Obesity Reviews analysis of all relevant published studies.

WPSI says screen all women annually for urinary incontinence
All women should be screened annually for urinary incontinence, according to new guidelines from the Women's Preventive Services Initiative (WPSI).

Read More: Incontinence News and Incontinence Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.