2 Surgeries May Work Equally Well for Incontinence
Doctors can choose the one they're more familiar with, expert says
"This finding is quite important as both procedures are safe and both had comparable success rates," he said. The study also showed that pelvic muscle training may only hold benefits for a small subset of patients undergoing surgery for apical vaginal prolapse, and that it's a question that needs further study, he noted.
If both surgeries work equally well, how do a surgeon and patient choose the best option? Trinh said based on the lack of evidence supporting one technique over the other, surgeons should offer their patients the technique they're most familiar with and comfortable performing.
From the patient's perspective, an important factor will be the consideration of side effects, he noted. "For example, the rate of neurologic pain requiring intervention was higher in the [sacrospinous ligament fixation] group," Trinh said. But ureteral obstruction -- a blockage in one or both tubes (ureters) that lead from the kidneys to the bladder -- was only seen in the [uterosacral ligament suspension] group.
"Patients should choose the approach they are most comfortable with, given the potential adverse outcomes of each," said Trinh.
Barber said in some cases a surgeon might make the call in the operating room, after starting surgery. Knowing both procedures are equally effective and safe is reassuring and allows the surgeon to provide the best option, he explained.
Barber said he hopes the study will also bring attention to an issue a lot of women live with but hesitate to seek treatment for because they believe there are no solutions.
"It's a condition that's very common. Studies like this not only provide us with useful information but they raise awareness, and patients may be more likely to bring it up with their doctors," Barber said.