Surgery for women with pelvic organ prolapse with or without stress urinary incontinence

Baeßler, Kaven; Christmann-Schmid, Corina; Maher, Christopher; Haya, Nir; Crawford, Tineke J; Brown, Julie

doi:10.1002/14651858.cd013108

Cited by 81 publications

(87 citation statements)

References 76 publications

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“…The authors speculated that extensive traction on the bladder neck made by ASC mesh and Burch colposuspension could be the reason of the failures and de novo urgency. On the contrary, little or no effect of Burch colposuspension on postoperative failures, de novo overactive bladder, or voiding dysfunction was demonstrated in a recent Cochrane review (31). In our study, four out of 43 patients underwent Burch colposuspension for SUI with RFC for vaginal vault suspension, and surgical success was obtained in three out of four patients at 16 months, which was coherent with the surgical success rate of Burch colposuspension group.…”

Section: Discussionsupporting

confidence: 82%

Long term outcomes of Burch colposuspension and transobturator tape and single incision needleless (DynaMesh ® - SIS minor) for the surgical treatment of female stress urinary incontinence patients who underwent combined pelvic reconstructive surgery or hysterectomy

Akdemir

Dincer

Buyukuysal

et al. 2020

Preprint

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Background: Women with stress urinary incontinence (SUI) often require combined pelvic reconstructive surgeries because of shared risk factors of pelvic organ prolapse The purpose of this study is to evaluate the efficacies of Burch colposuspension, the transobturator tape (TOT), and single-incision needleless (DynaMesh®- SIS minor) procedures in patients with SUI who also underwent combined pelvic reconstructive surgery or hysterectomy. Methods: We performed this prospective cohort study that comprising 142 patients who either underwent Burch colposuspension (n:43), TOT(n:40), or SIS(n:39) procedures along with pelvic reconstructive surgery or hysterectomy between January 2010 and July 2018. During the clinical follow-up, we analyzed the objective and subjective cure rates, improvement rates, along with failure and surgical success rates of SUI surgery. We assessed quality of life and symptom severity by Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), Sandvik Severity Index (SSI), Surgical Satisfaction Questionnaire (SSQ-8), Overactive Bladder Questionnaire V8 (OAB-V8), and Patient Global Impression of Improvement (PGI-I) scale scores. The primary outcome was surgical success, which was established when there was an improvement in patients or when the patients achieved objective or subjective cure, whereas secondary outcomes included intraoperative bladder injury, sling extrusion, de novo urgency, voiding dysfunction, length of hospital stay, and patient-reported outcomes in the quality of life questionnaires. Results: Surgical success rates were higher in the Burch group than the SIS group and also higher in the TOT group than in the SIS group (88.4% vs 61.5% and 87.5% vs 61.5% respectively, p=0.003) The complaints of urinary incontinence were higher and quality of life was lower in the SIS group than in the Burch group. In terms of IIQ-7, UDI-6, OAB-V8, SSI, and SSQ-8 scores, no difference was observed between Burch and TOT groups, and TOT and SIS groups.Conclusions: Both Burch and TOT are safe and effective procedures in patients with SUI who require additional pelvic surgeries. Although the surgical outcomes of SIS procedure in patients with SUI who underwent concomitant pelvic surgeries in our study were not promising, further randomized studies are needed to clarify these observations due to unclear data.

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Section: Discussionsupporting

confidence: 82%

Long term outcomes of Burch colposuspension and transobturator tape and single incision needleless (DynaMesh ® - SIS minor) for the surgical treatment of female stress urinary incontinence patients who underwent combined pelvic reconstructive surgery or hysterectomy

Akdemir

Dincer

Buyukuysal

et al. 2020

Preprint

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“…The LBC is an ideal procedure to perform during concomitant laparoscopy for repair of prolapse or other indications. However, the value of a concomitant Burch colposuspension at the time of laparoscopic pelvic floor repair has been questioned in a recent Cochrane review, suggesting little or no effect on post‐operative SUI, de novo OAB and voiding dysfunction …”

Section: Discussionmentioning

confidence: 99%

Long‐term patient‐reported outcomes after laparoscopic Burch colposuspension

Conrad

Pacquée

Saar

et al. 2019

Aust NZ J Obst Gynaeco

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Background:The negative media attention surrounding vaginal mesh procedures has seen a rise in demand for minimally invasive non-mesh options for the treatment of stress urinary incontinence (SUI). The laparoscopic Burch colposuspension (LBC) is a non-mesh alternative to synthetic midurethral slings (MUS) with similar short-term outcomes. However, long-term outcomes are not well established. Aims:To evaluate the long-term outcomes of LBC for treatment of SUI in women. Material and Methods: One hundred and fifty-one cases of LBC were performed by a single surgeon over two private hospital settings between January 2010 and January 2016. Follow-up subjective outcomes were obtained in 137 cases (90.7%) utilising standardised questionnaires. Primary outcome was successful treatment of SUI, defined as subjective cure or significant improvement of stress incontinence symptoms. Secondary outcomes included new-onset or worsened symptoms of overactive bladder (OAB), voiding dysfunction, prolapse, and perioperative complications. Results: One hundred and thirty-seven patients were analysed with a mean follow-up of 50.6 months (range: 13-89 months). Primary outcome of successful treatment was achieved in 90.5% of women. New-onset or worsened symptoms of OAB was reported in 10.2%, with a further 8.8% of women experiencing symptomatic voiding dysfunction. Sixteen patients (11.7%) reported new-onset or worsening symptoms of prolapse. There were no major surgical complications.Conclusions: LBC is a safe and effective long-term treatment for SUI, with low failure rates and minimal adverse outcomes. It is a suitable alternative for women with contraindications to mesh or those having concomitant laparoscopic procedures. K E Y W O R D Sfemale, follow-up studies, humans, laparoscopy, stress/surgery, urinary incontinence

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“…The majority of women with POP and urinary incontinence have symptoms of mixed urinary incontinence 1 . These disorders may improve or resolve after POP surgery, with the level of success depending on patient characteristics and type of surgery 2,3 . The cough stress test (CST) is recommended in the evaluation of female patients to identify the signs of SUI and is used as an outcome measure following SUI treatment.…”

Section: Introductionmentioning

confidence: 99%

“…1 These disorders may improve or resolve after POP surgery, with the level of success depending on patient characteristics and type of surgery. 2,3 The cough stress test (CST) is recommended in the evaluation of female patients to identify the signs of SUI and is used as an outcome measure following SUI treatment. The patient coughs and is observed for urine loss synchronous with the cough.…”

Section: Introductionmentioning

confidence: 99%

Cough stress tests to diagnose stress urinary incontinence in women with pelvic organ prolapse with indication for surgical treatment

Espuña‐Pons

Diez-Itza

Anglès‐Acedo

et al. 2020

Neurourology and Urodynamics

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Aims: To evaluate the diagnostic ability of different cough stress tests (CSTs) in women with pelvic organ prolapse (POP), performed during outpatient urogynaecological exams.Methods: Prospective, multicentre observational study involving women on waiting lists for POP surgery. With a subjectively full bladder, patients were asked to perform five different CSTs: without prolapse reduction ([a] standing, followed by [b] semilithotomy position); keeping semilithotomy position with prolapse reduced (by [c] posterior speculum, followed by [d] pessary); [e] standing again with the pessary in place. Primary outcome was positive CST in at least one of the five CSTs. Bladder volume was measured and symptoms of stress urinary incontinence (SUI) were detected by two validated questionnaires. Results: A total of 297 women completed all CSTs and were included in the analyses. Mean (SD) age, parity, and body mass index were 64.8 (9.9) years, 2.7 (1.3) deliveries, and 26.6 (3.4) kg/m 2 , respectively. In total, 99 women (33.3%) reported SUI symptoms. At least one positive CST was recorded in 152 patients (51.1%), and in 90 (59.2%) of these 152, a positive CST was observed only when POP was reduced (occult SUI). The CST was positive in 92 (92.9%) of the 99 patients with coexisting SUI symptoms and in 60 (30.3%) of the 205 asymptomatic patients. The percentage of patients with a positive CST was significantly lower when bladder volume was <200 mL vs ≥200 mL (P = .046). Conclusions:The identification of urinary leakage cases with CSTs is best achieved using multiple different patient positions, different prolapse reduction methods, and bladder volumes ≥200 mL. K E Y W O R D Scough stress test, pelvic organ prolapse, stress urinary incontinence ---

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Surgery for women with pelvic organ prolapse with or without stress urinary incontinence

Cited by 81 publications

References 76 publications

Long term outcomes of Burch colposuspension and transobturator tape and single incision needleless (DynaMesh ® - SIS minor) for the surgical treatment of female stress urinary incontinence patients who underwent combined pelvic reconstructive surgery or hysterectomy

Long term outcomes of Burch colposuspension and transobturator tape and single incision needleless (DynaMesh ® - SIS minor) for the surgical treatment of female stress urinary incontinence patients who underwent combined pelvic reconstructive surgery or hysterectomy

Long‐term patient‐reported outcomes after laparoscopic Burch colposuspension

Cough stress tests to diagnose stress urinary incontinence in women with pelvic organ prolapse with indication for surgical treatment

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