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Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial.
Int Urogynecol J. 2016 Jul; 27(7):1029-38.IU

Abstract

INTRODUCTION AND HYPOTHESIS

We compared pelvic organ prolapse (POP) repair with and without midurethral sling (MUS) in women with occult stress urinary incontinence (SUI).

METHODS

This was a randomized trial conducted by a consortium of 13 teaching hospitals assessing a parallel cohort of continent women with symptomatic stage II or greater POP. Women with occult SUI were randomly assigned to vaginal prolapse repair with or without MUS. Women without occult SUI received POP surgery. Main outcomes were the absence of SUI at the 12-month follow-up based on the Urogenital Distress Inventory and the need for additional treatment for SUI.

RESULTS

We evaluated 231 women, of whom 91 randomized as follows: 43 to POP surgery with and 47 without MUS. A greater number of women in the MUS group reported absence of SUI [86 % vs. 48 %; relative risk (RR) 1.79; 95 % confidence interval (CI) 1.29-2.48]. No women in the MUS group received additional treatment for postoperative SUI; six (13 %) in the control group had a secondary MUS. Women with occult SUI reported more urinary symptoms after POP surgery and more often underwent treatment for postoperative SUI than women without occult SUI.

CONCLUSIONS

Women with occult SUI had a higher risk of reporting SUI after POP surgery compared with women without occult SUI. Adding a MUS to POP surgery reduced the risk of postoperative SUI and the need for its treatment in women with occult SUI. Of women with occult SUI undergoing POP-only surgery, 13 % needed additional MUS. We found no differences in global impression of improvement and quality of life.

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Publisher Full Text (DOI)

Authors+Show Affiliations

van der Ploeg JM
Department of Obstetrics and Gynaecology, Martini Hospital, PO Box 30.033, 9700 RM, Groningen, The Netherlands. PloegJM@mzh.nl.
Oude Rengerink K
Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, PO Box 22.660, 1100 DD, Amsterdam, The Netherlands.
van der Steen A
Department of Obstetrics and Gynaecology, Ziekenhuisgroep Twente, PO Box 546, 7550 AM, Hengelo, The Netherlands.
van Leeuwen JH
Department of Obstetrics and Gynaecology, St. Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands.
van der Vaart CH
Department of Gynaecology and Reproductive Medicine, University Medical Centre Utrecht, PO Box 85.500, 3508 GA, Utrecht, The Netherlands.
Roovers JP
Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, PO Box 22.660, 1100 DD, Amsterdam, The Netherlands.
Dutch Urogynaecology Consortium
No affiliation info available

MeSH

AgedAged, 80 and overFemaleGynecologic Surgical ProceduresHumansMiddle AgedNetherlandsPelvic Organ ProlapsePostoperative ComplicationsQuality of LifeSuburethral SlingsUrinary Incontinence, Stress

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

26740197

Citation

van der Ploeg, J Marinus, et al. "Vaginal Prolapse Repair With or Without a Midurethral Sling in Women With Genital Prolapse and Occult Stress Urinary Incontinence: a Randomized Trial." International Urogynecology Journal, vol. 27, no. 7, 2016, pp. 1029-38.
van der Ploeg JM, Oude Rengerink K, van der Steen A, et al. Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial. Int Urogynecol J. 2016;27(7):1029-38.
van der Ploeg, J. M., Oude Rengerink, K., van der Steen, A., van Leeuwen, J. H., van der Vaart, C. H., & Roovers, J. P. (2016). Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial. International Urogynecology Journal, 27(7), 1029-38. https://doi.org/10.1007/s00192-015-2924-1
van der Ploeg JM, et al. Vaginal Prolapse Repair With or Without a Midurethral Sling in Women With Genital Prolapse and Occult Stress Urinary Incontinence: a Randomized Trial. Int Urogynecol J. 2016;27(7):1029-38. PubMed PMID: 26740197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial. AU - van der Ploeg,J Marinus, AU - Oude Rengerink,Katrien, AU - van der Steen,Annemarie, AU - van Leeuwen,Jules H Schagen, AU - van der Vaart,C Huub, AU - Roovers,Jan-Paul W R, AU - ,, Y1 - 2016/01/06/ PY - 2015/09/25/received PY - 2015/12/02/accepted PY - 2016/1/8/entrez PY - 2016/1/8/pubmed PY - 2017/8/31/medline KW - Masked KW - Midurethral sling KW - Occult KW - Pelvic organ prolapse KW - Randomised KW - Stress urinary incontinence SP - 1029 EP - 38 JF - International urogynecology journal JO - Int Urogynecol J VL - 27 IS - 7 N2 - INTRODUCTION AND HYPOTHESIS: We compared pelvic organ prolapse (POP) repair with and without midurethral sling (MUS) in women with occult stress urinary incontinence (SUI). METHODS: This was a randomized trial conducted by a consortium of 13 teaching hospitals assessing a parallel cohort of continent women with symptomatic stage II or greater POP. Women with occult SUI were randomly assigned to vaginal prolapse repair with or without MUS. Women without occult SUI received POP surgery. Main outcomes were the absence of SUI at the 12-month follow-up based on the Urogenital Distress Inventory and the need for additional treatment for SUI. RESULTS: We evaluated 231 women, of whom 91 randomized as follows: 43 to POP surgery with and 47 without MUS. A greater number of women in the MUS group reported absence of SUI [86 % vs. 48 %; relative risk (RR) 1.79; 95 % confidence interval (CI) 1.29-2.48]. No women in the MUS group received additional treatment for postoperative SUI; six (13 %) in the control group had a secondary MUS. Women with occult SUI reported more urinary symptoms after POP surgery and more often underwent treatment for postoperative SUI than women without occult SUI. CONCLUSIONS: Women with occult SUI had a higher risk of reporting SUI after POP surgery compared with women without occult SUI. Adding a MUS to POP surgery reduced the risk of postoperative SUI and the need for its treatment in women with occult SUI. Of women with occult SUI undergoing POP-only surgery, 13 % needed additional MUS. We found no differences in global impression of improvement and quality of life. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/26740197/Vaginal_prolapse_repair_with_or_without_a_midurethral_sling_in_women_with_genital_prolapse_and_occult_stress_urinary_incontinence:_a_randomized_trial_ DB - PRIME DP - Unbound Medicine ER -