“Using a prophylactic sling during prolapse repair significantly reduces postoperative stress incontinence,” said Anthony Visco, a representative of the American Urogynecologic Society at the 61st annual American Congress of Obstetricians and Gynecologists meeting, adding that this is true even if treatment is long delayed.
Women with pelvic organ prolapse (POP) but no associated urethral disfunction may experience stress urinary incontinence after the prolapse is surgically repaired. “The concern is that because of the large prolapse that maybe the urethra is getting kinked,” Visco said. Women not experiencing incontinence may experience bladder outlet obstruction when the prolapse is reduced. Inserting a sling at the time of surgical repair can prevent this, improving patient satisfaction.
More severe POP patients may have an obstructed, overactive bladder with ‘hidden,’ ‘potential’ or ‘occult’ stress incontinence. Women with severe prolapse fare best if evaluated for all three conditions prior to surgical repair.