Should we combine vaginal prolapse surgery with continence surgery?

Int Urogynecol J. 2019 Apr;30(4):577-580. doi: 10.1007/s00192-018-3808-y. Epub 2018 Nov 8.

Abstract

The risk of postoperative stress urinary incontinence (SUI) can be reduced by combining prolapse repair with continence surgery. However, more women face a serious adverse event (SAE) after vaginal prolapse surgery combined with a midurethral sling (MUS). It is difficult to predict a woman's individual postoperative SUI and SAE risk; therefore, weighing the benefits and risks of combination surgery is complex. We offer a concept that might help in considering combination surgery. According to this concept, women whose risk of needing subsequent surgery for postoperative SUI is on average 9% are likely to benefit from combination surgery.

Keywords: Combination surgery; Current opinion; Midurethral sling; Pelvic organ prolapse; Stress urinary incontinence.

MeSH terms

  • Female
  • Humans
  • Models, Theoretical*
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control
  • Postoperative Complications / surgery
  • Risk Assessment
  • Suburethral Slings*
  • Urinary Incontinence, Stress / etiology*
  • Urinary Incontinence, Stress / prevention & control
  • Urinary Incontinence, Stress / surgery
  • Uterine Prolapse / surgery*