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Current Bladder Dysfunction Reports
Published in: Current Bladder Dysfunction Reports 3/2012

01-09-2012 | Stress Incontinence and Pelvic Prolapse (RR Dmochowski, Section Editor)

Functional Outcomes for Incontinence and Prolapse Surgery

Authors: Saya Segal, Lily A. Arya, Ariana L. Smith

Published in: Current Bladder Dysfunction Reports | Issue 3/2012

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Abstract

The majority of women with pelvic organ prolapse and stress urinary incontinence report more than one symptom that affects urinary, bowel, or sexual function. Most research studies on outcomes following surgery for pelvic organ prolapse and stress incontinence focus on anatomic outcomes and relief of symptoms specific to prolapse and/or stress incontinence. Pelvic symptoms related to voiding function such as de novo urgency or incontinence, bowel function, and sexual function are clinically important outcomes but are infrequently reported. Deterioration of pelvic symptoms postoperatively is associated with decreased patient satisfaction, which underscores the importance of effectively assessing functional and anatomic treatment outcomes. Future studies of reconstructive pelvic surgery should routinely include multiple domain functional outcomes specifically addressing voiding, defecatory, and sexual function.
Literature
1.
Wu JM, Kawasaki A, Hundley AF, Dieter AA, Myers ER, Sung VW. Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Obstet Gynecol. 2011;205(3):230.e1–5.CrossRef
2.
• Pham T, Kenton K, Mueller E, Brubaker L. New pelvic symptoms are common after reconstructive pelvic surgery. Obstet Gynecol. 2009;200(1):88.e1–88.e5. This work outlines common pelvic symptoms that may influence patient satisfaction after pelvic reconstructive surgery. CrossRef
3.
Burgio KL, Brubaker L, Richter HE, Wai CY, Litman HJ, France DB, et al. Patient satisfaction with stress incontinence surgery. Neurourol Urodyn. 2010;29(8):1403–9.PubMedCrossRef
4.
Davis TL, Lukacz ES, Luber KM, Nager CW. Determinants of patient satisfaction after the tension-free vaginal tape procedure. Obstet Gynecol. 2004;191(1):176–81.CrossRef
5.
Elkadry EA, Kenton KS, FitzGerald MP, Shott S, Brubaker L. Patient-selected goals: A new perspective on surgical outcome. Obstet Gynecol. 2003;189(6):1551–7.CrossRef
6.
Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR, et al. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(3):178–86.PubMedCrossRef
7.
Antosh DD, Iglesia CB, Vora S, Sokol AI. Outcome assessment with blinded versus unblinded POP-Q exams. Obstet Gynecol. 2011;205(5):489.e1–4.CrossRef
8.
Foster RTS, Barber MD, Parasio MF, Walters MD, Weidner AC, Amundsen CL. A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. Am J Obstet Gynecol. 2007;197(1):82.e1–4.CrossRef
9.
Barber MD. Symptoms and outcome measures of pelvic organ prolapse. Clin Obstet Gynecol. 2005;48(3):648–61.PubMedCrossRef
10.
Walters MD, Karram MM, editors. Urogynecology and reconstructive pelvic surgery. 3rd ed. Philadelphia: Mosby Elsevier; 2007.
11.
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–6.PubMedCrossRef
12.
13.
Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: A randomized trial of three surgical techniques. Obstet Gynecol. 2001;185(6):1299–306.CrossRef
14.
Natale F, La Penna C, Padoa A, Agostini M, De Simone E, Cervigni M. A prospective, randomized, controlled study comparing gynemesh, a synthetic mesh, and pelvicol, a biologic graft, in the surgical treatment of recurrent cystocele. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(1):75–81.PubMedCrossRef
15.
Roovers JP, Oelke M. Clinical relevance of urodynamic investigation tests prior to surgical correction of genital prolapse: A literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(4):455–60.PubMedCrossRef
16.
Altman D, Vayrynen T, Engh ME, Axelsen S, Falconer C, Nordic Transvaginal Mesh Group. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011;364(19):1826–36.PubMedCrossRef
17.
Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Outcomes after anterior vaginal wall repair with mesh: A randomized, controlled trial with a 3 year follow-up. Obstet Gynecol. 2010;203(3):235.e1–8.CrossRef
18.
Nguyen JN, Burchette RJ. Outcome after anterior vaginal prolapse repair: A randomized controlled trial. Obstet Gynecol. 2008;111(4):891–8.PubMedCrossRef
19.
Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y, et al. A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse. Am J Obstet Gynecol. 2005;192(5):1649–54.PubMedCrossRef
20.
Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E. Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: A multicenter, randomized study. J Urol. 2007;177(1):192–5.PubMedCrossRef
21.
•• Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2010;(4)(4):CD004014. This systematic review reports functional outcomes from prolapse surgery trials.
22.
Maher CF, Qatawneh AM, Baessler K, Schluter PJ. Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol. 2004;104(4):685–9.PubMedCrossRef
23.
Paraiso MF, Barber MD, Muir TW, Walters MD. Rectocele repair: A randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol. 2006;195(6):1762–71.PubMedCrossRef
24.
Cundiff GW, Fenner D. Evaluation and treatment of women with rectocele: Focus on associated defecatory and sexual dysfunction. Obstet Gynecol. 2004;104(6):1403–21.PubMedCrossRef
25.
Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2000;182(6):1610–5.PubMedCrossRef
26.
Kahn MA, Stanton SL. Posterior colporrhaphy: Its effects on bowel and sexual function. Br J Obstet Gynaecol. 1997;104(1):82–6.PubMedCrossRef
27.
Komesu YM, Rogers RG, Kammerer-Doak DN, Barber MD, Olsen AL. Posterior repair and sexual function. Am J Obstet Gynecol. 2007;197(1):101.e1–6.CrossRef
28.
Altman D, Elmer C, Kiilholma P, Kinne I, Tegerstedt G, Falconer C, et al. Sexual dysfunction after trocar-guided transvaginal mesh repair of pelvic organ prolapse. Obstet Gynecol. 2009;113(1):127–33.PubMed
29.
Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: A prospective randomized study with long-term outcome evaluation. Obstet Gynecol. 1996;175(6):1418–22.CrossRef
30.
Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: A prospective randomized study. Obstet Gynecol. 2004;190(1):20–6.CrossRef
31.
Dietz V, van der Vaart CH, van der Graaf Y, Heintz P, Schraffordt Koops SE. One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: A randomized study. Int Urogynecol J. 2010;21(2):209–16.PubMedCrossRef
32.
Weber AM, Walters MD, Schover LR, Church JM, Piedmonte MR. Functional outcomes and satisfaction after abdominal hysterectomy. Obstet Gynecol. 1999;181(3):530–5.CrossRef
33.
Dietz V, Huisman M, de Jong J. Functional outcomes after sacrospinous hysteropexy for uterine descensus. Int Urogynecol J. 2008;19:747–52.CrossRef
34.
Given Jr FT. “Posterior culdeplasty”: Revisited. Am J Obstet Gynecol. 1985;153(2):135–9.PubMed
35.
Webb MJ, Aronson MP, Ferguson LK, Lee RA. Posthysterectomy vaginal vault prolapse: Primary repair in 693 patients. Obstet Gynecol. 1998;92(2):281–5.PubMedCrossRef
36.
Colombo M, Milani R. Sacrospinous ligament fixation and modified McCall culdoplasty during vaginal hysterectomy for advanced uterovaginal prolapse. Obstet Gynecol. 1998;179(1):13–20.CrossRef
37.
Margulies RU, Rogers MAM, Morgan DM. Outcomes of transvaginal uterosacral ligament suspension: Systematic review and metaanalysis. Obstet Gynecol. 2010;202(2):124–34.CrossRef
38.
Silva WA, Pauls RN, Segal JL, Rooney CM, Kleeman SD, Karram MM. Uterosacral ligament vault suspension: Five-year outcomes. Obstet Gynecol. 2006;108(2):255–63.PubMedCrossRef
39.
Antovska SV, Dimitrov DG. Vaginosacral colpopexy (VSC)–a new modification of the mc call operation using vaginosacral ligaments as autologous sliding grafts in posthysterectomy vault prolapse. Bratisl Lek Listy. 2006;107(3):62–72.PubMed
40.
Amundsen CL, Flynn BJ, Webster GD. Anatomical correction of vaginal vault prolapse by uterosacral ligament fixation in women who also require a pubovaginal sling. J Urol. 2003;169(5):1770–4.PubMedCrossRef
41.
Burgio KL, Nygaard IE, Richter HE, Brubaker L, Gutman RE, Leng W, et al. Bladder symptoms 1 year after abdominal sacrocolpopexy with and without burch colposuspension in women without preoperative stress incontinence symptoms. Am J Obstet Gynecol. 2007;197(6):647.e1–6.CrossRef
42.
Brubaker L, Nygaard I, Richter HE, Visco A, Weber AM, Cundiff GW, et al. Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence. Obstet Gynecol. 2008;112(1):49–55.PubMedCrossRef
43.
Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM, et al. Abdominal sacrocolpopexy: A comprehensive review. Obstet Gynecol. 2004;104(4):805–23.PubMedCrossRef
44.
Visco AG, Brubaker L, Nygaard I, Richter HE, Cundiff G, Fine P, et al. The role of preoperative urodynamic testing in stress-continent women undergoing sacrocolpopexy: The colpopexy and urinary reduction efforts (CARE) randomized surgical trial. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(5):607–14.PubMedCrossRef
45.
Brubaker L, Cundiff GW, Fine P, Nygaard I, Richter HE, Visco AG, et al. Abdominal sacrocolpopexy with burch colposuspension to reduce urinary stress incontinence. N Engl J Med. 2006;354(15):1557–66.PubMedCrossRef
46.
Kahn MA, Breitkopf CR, Valley MT, Woodman PJ, O’Boyle AL, Bland DI, et al. Pelvic organ support study (POSST) and bowel symptoms: Straining at stool is associated with perineal and anterior vaginal descent in a general gynecologic population. Am J Obstet Gynecol. 2005;192(5):1516–22.PubMedCrossRef
47.
Bradley CS, Brown MB, Cundiff GW, Goode PS, Kenton KS, Nygaard IE, et al. Bowel symptoms in women planning surgery for pelvic organ prolapse. Am J Obstet Gynecol. 2006;195(6):1814–9.PubMedCrossRef
48.
Bradley CS, Nygaard IE, Brown MB, Gutman RE, Kenton KS, Whitehead WE, et al. Bowel symptoms in women 1 year after sacrocolpopexy. Am J Obstet Gynecol. 2007;197(6):642.e1–8.CrossRef
49.
Handa VL, Zyczynski HM, Brubaker L, Nygaard I, Janz NK, Richter HE, et al. Sexual function before and after sacrocolpopexy for pelvic organ prolapse. Am J Obstet Gynecol. 2007;197(6):629.e1–6.CrossRef
50.
FitzGerald MP, Brubaker L. Colpocleisis and urinary incontinence. Am J Obstet Gynecol. 2003;189(5):1241–4.PubMedCrossRef
51.
Fitzgerald MP, Richter HE, Bradley CS, Ye W, Visco AC, Cundiff GW, et al. Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1603–9.PubMedCrossRef
52.
Smith AL, Karp DR, Lefevre R, Aguilar VC, Davila GW. LeFort colpocleisis and stress incontinence: Weighing the risk of voiding dysfunction with sling placement. Int Urogynecol J. 2011;22(11):1357–62.PubMedCrossRef
53.
Gutman RE, Bradley CS, Ye W, Markland AD, Whitehead WE, Fitzgerald MP, et al. Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse. Int Urogynecol J. 2010;21(4):461–6.PubMedCrossRef
54.
Barber MD, Amundsen CL, Paraiso MF, Weidner AC, Romero A, Walters MD. Quality of life after surgery for genital prolapse in elderly women: Obliterative and reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(7):799–806.PubMedCrossRef
55.
von Pechmann WS, Mutone M, Fyffe J, Hale DS. Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2003;189(1):121–6.CrossRef
56.
Rozet F, Mandron E, Arroyo C, Andrews H, Cathelineau X, Mombet A, et al. Laparoscopic sacral colpopexy approach for genito-urinary prolapse: Experience with 363 cases. Eur Urol. 2005;47(2):230–6.PubMedCrossRef
57.
Ganatra AM, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X, et al. The current status of laparoscopic sacrocolpopexy: A review. Eur Urol. 2009;55(5):1089–105.PubMedCrossRef
58.
Siddiqui NY, Geller EJ, Visco AG. Symptomatic and anatomic 1-year outcomes after robotic and abdominal sacrocolpopexy. Am J Obstet Gynecol. 2012.
59.
Paraiso MF, Jelovsek JE, Frick A, Chen CC, Barber MD. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: A randomized controlled trial. Obstet Gynecol. 2011;118(5):1005–13.PubMedCrossRef
60.
Geller EJ, Parnell BA, Dunivan GC. Robotic vs abdominal sacrocolpopexy: 44-month pelvic floor outcomes. Urology. 2012;79(3):532–6.PubMedCrossRef
61.
Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183(5):1906–14.PubMedCrossRef
62.
Alperin M, Abrahams-Gessel S, Wakamatsu MM. Development of de novo urge incontinence in women post sling: The role of preoperative urodynamics in assessing the risk. Neurourol Urodyn. 2008;27(5):407–11.PubMedCrossRef
63.
Hilton P. Urinary incontinence during sexual intercourse: A common, but rarely volunteered, symptom. Br J Obstet Gynaecol. 1988;95(4):377–81.PubMedCrossRef
64.
Rogers RG, Kammerer-Doak D, Darrow A, Murray K, Qualls C, Olsen A, et al. Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study. Obstet Gynecol. 2006;195(5):1–4.
65.
Palva K, Nilsson CG. Prevalence of urinary urgency symptoms decreases by mid-urethral sling procedures for treatment of stress incontinence. Int Urogynecol J. 2011;22(10):1241–7.PubMedCrossRef
66.
Kulseng-Hanssen S, Husby H, Schiotz HA. Follow-up of TVT operations in 1,113 women with mixed urinary incontinence at 7 and 38 months. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(3):391–6.PubMedCrossRef
67.
Carey MP, Goh JT, Rosamilia A, Cornish A, Gordon I, Hawthorne G, et al. Laparoscopic versus open burch colposuspension: A randomised controlled trial. BJOG. 2006;113(9):999–1006.PubMedCrossRef
68.
Paraiso MF, Falcone T, Walters MD. Laparoscopic surgery for genuine stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1999;10(4):237–47.PubMedCrossRef
69.
Brubaker L, Chiang S, Zyczynski H, Norton P, Kalinoski DL, Stoddard A, et al. The impact of stress incontinence surgery on female sexual function. Obstet Gynecol. 2009;200(5):562.e1–7.CrossRef
70.
Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007;356(21):2143–55.PubMedCrossRef
71.
Morgan Jr TO, Westney OL, McGuire EJ. Pubovaginal sling: 4-YEAR outcome analysis and quality of life assessment. J Urol. 2000;163(6):1845–8.PubMedCrossRef
72.
Paraiso MF, Walters MD, Karram MM, Barber MD. Laparoscopic burch colposuspension versus tension-free vaginal tape: A randomized trial. Obstet Gynecol. 2004;104(6):1249–58.PubMedCrossRef
73.
Nilsson CG, Kuuva N. The tension-free vaginal tape procedure is successful in the majority of women with indications for surgical treatment of urinary stress incontinence. BJOG: An International Journal of Obstetrics & Gynaecology. 2001;108(4):414–9.CrossRef
74.
Richter HE, Albo ME, Zyczynski HM, Kenton K, Norton PA, Sirls LT, et al. Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med. 2010;362(22):2066–76.PubMedCrossRef
Metadata
Title
Functional Outcomes for Incontinence and Prolapse Surgery
Authors
Saya Segal
Lily A. Arya
Ariana L. Smith
Publication date
01-09-2012
Publisher
Current Science Inc.
Published in
Current Bladder Dysfunction Reports / Issue 3/2012
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-012-0136-9

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