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) 27:10291038 DOI 10.1007/s00192-015-2924-1

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Vaginal prolapse repair with or without a midurethralsling in women with genital prolapse and occult stress urinary incontinence: a randomized trial

J. Marinus van der Ploeg1 & Katrien Oude Rengerink2 & Annemarie van der Steen3 &

Jules H. Schagen van Leeuwen4 & C. Huub van der Vaart5 & Jan-Paul W. R. Roovers2 &

On behalf of the Dutch Urogynaecology Consortium

Received: 25 September 2015 /Accepted: 2 December 2015 /Published online: 6 January 2016 # The International Urogynecological Association 2015

AbstractIntroduction and hypothesis We compared pelvic organ pro-lapse (POP) repair with and without midurethral sling (MUS) in women with occult stress urinary incontinence (SUI). Methods This was a randomized trial conducted by a consortium of 13 teaching hospitals assessing a parallel cohort of continent women with symptomatic stage II or greater POP. Women with occult SUI were randomly assigned to vaginal prolapse repair with or without MUS. Women without occult SUI received POP surgery. Main outcomes were the absence of SUI at the 12-month follow-up based on the Urogenital Distress Inventory and the need for additional treatment for SUI.

Results We evaluated 231 women, of whom 91 randomized as follows: 43 to POP surgery with and 47 without MUS. A greater number of women in the MUS group reported absence of SUI [86 % vs. 48 %; relative risk (RR) 1.79; 95 % confidence interval (CI) 1.292.48]. No women in the MUS group received additional treatment for postoperative SUI; six (13 %) in the control group had a secondary MUS. Women with occult SUI reported more urinary symptoms after POP surgery and more often underwent treatment for postoperative SUI than women without occult SUI.

Conclusions Women with occult SUI had a higher risk of reporting SUI after POP surgery compared with women with-

The complete list of authors and collaborators from the Dutch Urogynaecology Consortium are listed in Supporting Information, Table A1 of the BAppendix^.

Trial registration The Netherlands Trial Register http://dx.doi.org/http://www.trialregistry.nl/NTR1070

Web End =NTR1070 (http://dx.doi.org/http://www.trialregistry.nl/NTR1070

Web End =www. http://dx.doi.org/http://www.trialregistry.nl/NTR1070

Web End =trialregister.nl ).

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