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The purpose of our study was to examine the incidence of prolapse in a group of women who had had an isolated Tanagho modification of the Burch colposuspension performed without significant pelvic organ prolapse preoperatively. Sixty women were identified who underwent an isolated Burch procedure for genuine stress incontinence between 1991 and 1999. Thirty-four women returned for postoperative Pelvic Organ Prolapse Quantification (POP-Q) staging evaluation. Overall, 6 (17.6%) had stage II anterior prolapse. Eleven (32.4%) had stage II posterior prolapse. Three (8.8%) had stage II uterine prolapse. None of these patients with identified support defects was symptomatic. Two patients had subsequently undergone vaginal hysterectomy. One had this performed for dysfunctional uterine bleeding 3 years after her Burch procedure. One patient developed symptomatic uterine prolapse and underwent a vaginal hysterectomy 5 months after her Burch procedure. The majority of patients undergoing an isolated Tanagho modification Burch procedure without preoperative prolapse do not appear to be placed at increased risk for subsequent operative intervention.

Pelvic organ prolapse is a common worldwide problem. Recent advances in our understanding of its pathophysiology, along with progress made in the evaluation and treatment of pelvic support defects, are discussed. Although the pathophysiology of this condition is still not completely understood, genetic factors and environmental factors are involved. Understanding these factors better will help us to approach treatment of pelvic organ prolapse in a more logical manner. Multiple surgical techniques are available for pelvic relaxation, with a wide range of success rates ranging from 77 to 97% for various procedures. New techniques need to be studied further before being incorporated into routine practice. Better standardization of evaluation methods can help in such clinical studies.

After anterior sacrospinous vault suspension, vaginal length and apical suspension were slightly increased, and recurrent anterior vaginal prolapse decreased compared with the posterior sacrospinous suspension technique. Upper vaginal caliber and sexual function appear well preserved using either technique.

Twelve weeks of InTone usage resulted in significant objective and subjective reductions in UI. Device usability was very good.