By adding a bladder-supporting procedure known as Burch colposuspension to the operation, women who had not been bothered by stress incontinence before the procedure were much less likely to have this problem after their prolapse surgery.

“We found that without the Burch procedure, one in every four women developed some stress incontinence that they considered bothersome. We were able to reduce this to one in every 20 women by adding the four stitches of the Burch procedure,” said principal investigator Linda Brubaker, MD, a pelvic medicine specialist at Loyola University Health System, Maywood, Ill.

A total of 322 women, who were scheduled for a form of prolapse surgery called sacrocolpopexy, were studied in nine centres across the United States. The women were randomly selected to receive the Burch procedure, in which the vagina is sutured to the pelvic ligaments on either side to support the urinary sphincter. Secured in this way, the urinary sphincter, located at the bottom of the bladder is prevented from moving in a way that may allow urine to leak.

“This is the first time we’ve ever had a large, randomised trial that shows that we can prevent the development of stress incontinence,” says Brubaker, who is assistant dean of clinical and translational research and professor, department of obstetrics & gynaecology and urology, Loyola University Chicago Stritch School of Medicine. The study was known as the CARE trial (Colpopexy And Urinary Reduction Efforts.)

MEDICA.de; Source: Loyola University Health System