Device Managed Effective Incontinence

Women in this study underwent surgery for pelvic organ prolapse. Prolapse occurs when the pelvic organs fall and cause the vaginal wall to protrude outside of the body. About 1 in 5 women will undergo this surgery in her lifetime. Those who undergo surgery for this disorder are at risk for urinary incontinence following the procedure. As a result, surgeons commonly add a midurethral sling at the time of surgery to prevent this disorder.

“One-quarter of women develop incontinence after prolapse surgery, so it is critical that we have an effective option to manage this issue,” said Doctor Kimberly. “Slings do come with risks though, so one approach might be to only treat patients who develop incontinence after surgery.”

This study evaluated 322 women at three months and 12 months following surgery. Half of the women received a midurethral sling and the other half received sham incisions. At three months, the rate of urinary incontinence was 23.6 per cent in the sling group and 49.4 per cent in the sham group. At 12 months, urinary incontinence was present in 27.3 per cent and 43 per cent, respectively. However, the rates of side effects were higher in the sling group. These included bladder perforations (6.7 versus 0 per cent), urinary-tract infections (31 versus 18.3 per cent), major bleeding complications (3.1 versus 0 per cent) and incomplete bladder emptying six weeks following surgery (3.7 versus 0 per cent). There were no significant differences between groups in changes in overall health, other pelvic-floor symptoms, sexual function and pain.

“Slings continue to be a valuable option for certain women, but we should avoid using them with all patients undergoing a procedure for pelvic-organ prolapse,” Kenton said. “This research reinforces the importance of counseling women on the risks and benefits of prolapse surgery prior to the procedure.”; Source: Loyola University Health System (LUHS)