Prophylactic Slings May Prevent Incontinence After POP Repair

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GLASGOW—Prophylactic mid-urethral slings prevent urinary incontinence (UI) in women undergoing pelvic organ prolapse (POP) repair, according to study findings presented at the International Continence Society annual meeting.

The study included 337 women with no reported UI symptoms who underwent POP repair. Subjects had a mean age of 63 years. The researchers, led by John T. Wei, MD, of the University of Michigan in Ann Arbor, randomized subjects to receive prophylactic tension-free vaginal tape (165 patients) or a sham incision (172 patients). The incidence of UI was significantly lower in the TVT arm than the sham incision group at three months (24% vs. 49%) and 12 months (27.3% vs. 43%).

At 12 months, even allowing for additional urinary incontinence treatment in the sham incision group, the investigators noted a significant twofold increased risk of experiencing post-operative urinary incontinence after adjusting for confounding variables. The addition of the prophylactic TVT procedure was associated with more bladder and bleeding events, though none qualified as serious adverse events. Dr. Wei's group concluded that, on average, six women would have to undergo a prophylactic sling procedure to prevent one additional case of UI at 12 months.

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