Abstract
Background/aimTo investigate the risk of de novo stress urinary incontinence (SUI) occurrence in women who were treated for pelvic organ prolapse (POP) with sacrospinous ligament fixation (SSLF) in addition to vaginal hysterectomy (VAH) and antero-posterior colporrhaphy (CAP) over a 24-month follow-up period. Materials and methodsA prospective randomized study was designed. Women without occult or obvious SUI were randomized into either one of the study groups: Group 1: VAH + CAP, and Group 2: VAH + CAP + SSLF. Postoperatively, the patients were reevaluated for de novo SUI occurrence.ResultsA total of 150 women were analyzed [G1 = VAH + CAP (n: 77) and G2 = VAH + CAP + SSLF (n: 73)]. Mean age, parity, body mass index, menopausal status, and preoperative POP degree, grade 1 and grade 2-3 cystocele and rectocele frequencies were similar between the 2 groups. During follow-up period, de novo SUI developed in 7 patients (9.1%) of Group 1, and in 6 patients (8.2%) of Group 2 (P > 0.05). In Groups 1 and 2, POP recurrence occurred in 5 (6.4%) vs. 1 (1.3%) cases,respectively (P < 0.05).ConclusionIn patients undergoing surgery for POP, the addition of SSLF did not result in an increased rate of de novo SUI. Careful patient selection, and informing the patients about the risks and benefits of the planned surgical procedure are essential steps in each case of POP.
Highlights
Pelvic organ prolapsed (POP) is a very common condition, approaching nearly 50% in middle aged women [1]
During follow-up period, de novo Stress urinary incontinence (SUI) developed in 7 patients (9.1%) of Group 1, and in 6 patients (8.2%) of Group 2 (P > 0.05)
In patients undergoing surgery for POP, the addition of sacrospinous ligament fixation (SSLF) did not result in an increased rate of de novo SUI
Summary
Pelvic organ prolapsed (POP) is a very common condition, approaching nearly 50% in middle aged women [1]. POP is corrected surgically in many of the cases. POP degree, menopausal status, patient and surgeon preference are the most important contributors on final treatment choice. Vaginal hysterectomy (VAH) is commonly selected, and colporrhaphy is frequently performed as a part of this procedure in patients who have completed childbearing [2]. De novo SUI might occur after POP surgery, and further might even require additional surgeries [3]. Rates of de novo SUI after POP surgery have been reported between 9.9% and 51% [4,5,6,7,8,9,10,11]
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