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Surgery for women with pelvic organ prolapse (POP) with or without continence procedures

Cochrane Review; 19 trials (2717 women).

Key results

Surgery to treat women with POP and stress urinary incontinence:
In two studies of moderate quality, women with stress incontinence benefited from an additional continence procedure (mid‐urethral sling) at the time of vaginal prolapse repair for the outcome of postoperative stress urinary incontinence (SUI). The continence procedure might also be postponed for three months after prolapse surgery with similar success rates. In this situation, some women might avoid an additional continence operation.

It is unclear whether abdominal prolapse repair (sacrocolpopexy or sacrohysteropexy) with an additional abdominal continence procedure (Burch colposuspension) improves urinary leakage after surgery.

Surgery to treat women with POP and occult stress urinary incontinence:
Five moderate‐quality studies of women with prolapse and observed urinary leakage during vaginal examination with a reduced prolapse reported benefit from an additional continence procedure (mid‐urethral sling) when undergoing vaginal prolapse surgery.

Surgery to treat continent women with POP:
Evidence from one moderate‐quality study was inconclusive as to any benefit of an additional continence procedure (mid‐urethral sling) when women underwent vaginal prolapse surgery.

Read the full Cochrane Review here

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1. A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. On physical examination, bibasilar crackles were noted on lung auscultation.

2. A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She cares for a small kennel with approximately eight dogs rescued from the streets, with physical examination revealing multiple small vesicles.

3. A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs.

4. Patient in late teens presenting after a collapse, with no chest pain and no previous cardiac history.

This article synthesizes findings from multiple studies on surgical interventions to treat various cases related to pelvic organ prolapse.