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06.01.2016 | Original Article

Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial

verfasst von: J. Marinus van der Ploeg, Katrien Oude Rengerink, Annemarie van der Steen, Jules H. Schagen van Leeuwen, C. Huub van der Vaart, Jan-Paul W. R. Roovers, On behalf of the Dutch Urogynaecology Consortium

Erschienen in: International Urogynecology Journal | Ausgabe 7/2016

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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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Titel: Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial
verfasst von: J. Marinus van der Ploeg
Katrien Oude Rengerink
Annemarie van der Steen
Jules H. Schagen van Leeuwen
C. Huub van der Vaart
Jan-Paul W. R. Roovers
On behalf of the Dutch Urogynaecology Consortium
Publikationsdatum: 06.01.2016
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 7/2016
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2924-1

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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