Skip to main content

Advertisement

SpringerLink
Log in

Should we combine vaginal prolapse surgery with continence surgery?

  • Clinical Opinion
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. van der Ploeg JM, van der Steen A, Zwolsman S, van der Vaart CH, Roovers J. Prolapse surgery with or without incontinence procedure: a systematic review and meta-analysis. BJOG. 2018;125(3):289–97.

  2. Schierlitz L, Dwyer PL, Rosamilia A, De Souza A, Murray C, Thomas E, et al. Pelvic organ prolapse surgery with and without tension-free vaginal tape in women with occult or asymptomatic urodynamic stress incontinence: a randomised controlled trial. Int Urogynecol J. 2014;25(1):33–40.

    Article  PubMed  Google Scholar 

  3. Wei JT, Nygaard I, Richter HE, Nager CW, Barber MD, Kenton K, et al. A midurethral sling to reduce incontinence after vaginal prolapse repair. N Engl J Med. 2012;366(25):2358–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. van der Ploeg JM, Oude Rengerink K, van der Steen A, van Leeuwen JH, Stekelenburg J, Bongers MY, et al. Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial. BJOG. 2015;122(7):1022–30.

    Article  PubMed  Google Scholar 

  5. van der Ploeg JM, Oude Rengerink K, van der Steen A, van Leeuwen JH, van der Vaart CH, Roovers JP, et al. Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial. Int Urogynecol J. 2016;27(7):1029–38.

    Article  PubMed  Google Scholar 

  6. Mitropoulos D, Artibani W, Graefen M, Remzi M, Rouprêt M, Truss M. Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Eur Urol. 2012;61(2):341–9.

    Article  PubMed  Google Scholar 

  7. Schraffordt Koops SE, Bisseling TM, Heintz AP, Vervest HA. Prospective analysis of complications of tension-free vaginal tape from the Netherlands tension-free vaginal tape study. Am J Obstet Gynecol. 2005;193(1):45–52.

    Article  PubMed  Google Scholar 

  8. Ford AA, Rogerson L, Cody JD, Aluko P, Ogah JA. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;7:CD006375.

    PubMed  Google Scholar 

  9. Erekson E, Murchison RL, Gerjevic KA, Meljen VT, Strohbehn K. Major postoperative complications following surgical procedures for pelvic organ prolapse: a secondary database analysis of the American College of Surgeons National Surgical Quality Improvement Program. Am J Obstet Gynecol. 2017;217(5):608.e17.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Martini Hospital, PO Box 30.033, 9700 RM, Groningen, The Netherlands

    J. Marinus van der Ploeg

  2. Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, PO Box 22.660, 1100 DD, Amsterdam, The Netherlands

    Jan-Paul W. R. Roovers

Authors
  1. J. Marinus van der Ploeg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan-Paul W. R. Roovers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Marinus van der Ploeg.

Ethics declarations

Conflicts of interest

J. Marinus van der Ploeg: the author reports no conflict of interest.

Jan-Paul W.R. Roovers: medical consultant for American Medical Systems (AMS).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

van der Ploeg, J.M., Roovers, JP.W.R. Should we combine vaginal prolapse surgery with continence surgery?. Int Urogynecol J 30, 577–580 (2019). https://doi.org/10.1007/s00192-018-3808-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-018-3808-y

Keywords

Search

Navigation