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    Surgery May Avoid Urinary Incontinence

    Procedure Used for Women Getting Surgery for Pelvic Prolapse
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    April 12, 2006 -- For women with pelvic-organ prolapse, getting two operations at the same time may help avoid new cases of stress incontinence.

    In pelvic-organ prolapse, the pelvic muscles and connective tissue are weak or injured. As a result, the patient's bladder, bowel, and uterus press down on (and possibly bulge through) the vagina.

    The condition is common, and surgery can correct it. Although urinary stress incontinence can coincide with pelvic-organ prolapse, it may also develop for other reasons and can happen after surgical repair of the prolapse. People with stress incontinence have leaking of urine while coughing, laughing, sneezing, exercising, lifting, or bending over.

    If stress urinary incontinence develops, a second surgery -- called a Burch colposuspension -- can be done. Doing both operations at once might be better than taking the wait-and-see approach, doctors report in The New England Journal of Medicine.

    'Important Advance'

    The study was funded by the National Institute of Child Health and Human Development (NICHD), a branch of the National Institutes of Health.

    The new study is "an important advance in treatment for a large number of women," NICHD Director Duane Alexander, MD, says in a news release.

    Each year, more than 200,000 women have prolapse surgery, Alexander notes. "These research findings could prevent incontinence in many of them," he says.

    The researchers who conducted the study included Linda Brubaker, MD. She works in the obstetrics and gynecology department of Loyola University Medical Center in Maywood, Ill.

    Brubaker's team studied 322 women scheduled for prolapse surgery. None of the women had stress urinary incontinence before prolapse surgery.

    All of the women got a type of prolapse surgery called abdominal sacrocolpopexy. In addition, 157 women also got Burch colposuspension.

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