A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse

Monday, 1 Septembr 2008 - Miedel et al. (2008) evaluated anatomic, functional, short- and long-term outcome of vaginal surgery for pelvic organ prolapse.

The prospective observational study included 185 consecutive women planned for vaginal prolapse reconstructive surgery. Stage of prolapse, urinary incontinence (UI), bowel and mechanical symptoms were assessed preoperatively and at 1, 3 and 5 years postoperatively. The mean follow-up time was 53 months.

The anatomic recurrence rate was 41.1% but less than half of them were symptomatic. Anterior compartment was most prone for recurrence and the majority of the recurrences took place within the first year. UI remained at the same level at 1-year follow-up. De novo urge occurred in 22.6% and de novo stress incontinence in 6.0%. An improvement was seen in difficulty in emptying bowel 1 year after surgery (54%). Patients were primarily cured from mechanical symptoms. Re-operation rate was 9.7%; if additional operation for incontinence was included, it was13.5%.

In conclusion, authors’ study supports a certain improvement of stress and urge urinary
incontinence after an anterior repair but also demonstrates the difficulty in predicting outcome of urinary incontinence after prolapse surgery in any individual woman. Some will note improvement and some women will acquire another type of incontinence. The functional outcome of prolapse
surgery is complex and not always foreseeable.

Miedel, A., Tegerstedt, G., Morlin, B., & Hammarstrom, M. (2008). A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct, DOI 10.1007/s00192-008-0702-z.

Authors: Miedel et al.

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