Skip to main content

Advertisement

SpringerLink
Log in

Is there any evidence to advocate SUI prevention in continent women undergoing prolapse repair? An overview

  • Review
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Postoperative SUI prevention at the time of prolapse surgery is still a challenging issue. Recent findings suggested that a systematic prophylactic Burch colposuspension could be performed in continent women undergoing a sacral colpopexy. The aim of this paper is to collect relevant literature in order to suggest a management strategy. A thorough PubMed research of all papers in the English language was conducted. Evidence-based medicine was analyzed and current unanswered questions were discussed. Despite evident limitations, it appears to be some benefit from preoperative screening with a stress test during prolapse reduction. In continent patient with a positive stress test, adding a preventive procedure could be fully justified. In regard to contradictory published data, when negative stress test, patient counseling is important and the ratio of risk–benefit should be rigorously discussed. Further randomized controlled studies are needed to support either a prophylactic or a second-step strategy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Latini JM, Kreder KJ Jr (2005) Associated pelvic organ prolapse in women with stress urinary incontinence: when to operate? Curr Opin Urol 15:380–385

    Article  PubMed  Google Scholar 

  2. Rogers RG (2006) The vexing problem of hidden incontinence. N Engl J Med 354:1627–1629

    Article  PubMed  CAS  Google Scholar 

  3. Stanton SL, Hilton P, Norton C, Cardozo L (1982) Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence. Br J Obstet Gynaecol 89:459–463

    PubMed  CAS  Google Scholar 

  4. Borstad E, Rud T (1989) The risk of developing urinary stress-incontinence after vaginal repair in continent women. A clinical and urodynamic follow-up study. Acta Obstet Gynecol Scand 68:545–549

    Article  PubMed  CAS  Google Scholar 

  5. Clark AL, Gregory T, Smith VJ, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267

    Article  PubMed  Google Scholar 

  6. Brubaker L, Bump R, Fynes M, Jacquetin B, Karram M, Kreder K, Maher C, Norton P (2005) Surgery for pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence (vol. 2: management), 3rd edn. Heath Publ. Ltd., Plymouth, pp 1371–1401

    Google Scholar 

  7. Haessler AL, Lin LL, Ho MH, Betson LH, Bhatia NN (2005) Reevaluating occult incontinence. Curr Opin Obstet Gynecol 17:535–540

    Article  PubMed  Google Scholar 

  8. Chaikin DC, Groutz A, Blaivas JG (2000) Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse. J Urol 163:531–534

    Article  PubMed  CAS  Google Scholar 

  9. Gordon D, Groutz A, Wolman I, Lessing JB, David MP (1999) Development of postoperative urinary stress incontinence in clinically continent patients undergoing prophylactic Kelly plication during genitourinary prolapse repair. Neurourol Urodyn 18:193–197

    Article  PubMed  CAS  Google Scholar 

  10. Richardson DA, Bent AE, Ostergard DR (1983) The effect of uterovaginal prolapse on urethrovesical pressure dynamics. Am J Obstet Gynecol 146:901–905

    PubMed  CAS  Google Scholar 

  11. Rosenzweig BA, Pushkin S, Blumenfeld D, Bhatia NN (1992) Prevalence of abnormal urodynamic test results in continent women with severe genitourinary prolapse. Obstet Gynecol 79:539–542

    PubMed  CAS  Google Scholar 

  12. Colombo M, Maggioni A, Scalambrino S, Vitobello D, Milani R (1997) Surgery for genitourinary prolapse and stress incontinence: a randomized trial of posterior pubourethral ligament plication and Pereyra suspension. Am J Obstet Gynecol 176:337–343

    Article  PubMed  CAS  Google Scholar 

  13. Delancey JO (1996) Stress urinary incontinence: where are we now, where should we go? Am J Obstet Gynecol 175:311–319

    Article  PubMed  CAS  Google Scholar 

  14. Bergman A, Koonings PP, Ballard CA (1988) Predicting postoperative urinary incontinence development in women undergoing operation for genitourinary prolapse. Am J Obstet Gynecol 158:1171–1175

    PubMed  CAS  Google Scholar 

  15. Bump RC, Fantl JA, Hurt WG (1988) The mechanism of urinary continence in women with severe uterovaginal prolapse: results of barrier studies. Obstet Gynecol 72:291–295

    PubMed  CAS  Google Scholar 

  16. Bump RC, Hurt WG, Theofrastous JP, Addison WA, Fantl JA, Wyman JF, McClish DK (1996) Randomized prospective comparison of needle colposuspension versus endopelvic fascia plication for potential stress incontinence prophylaxis in women undergoing vaginal reconstruction for stage III or IV pelvic organ prolapse. The Continence Program for Women Research Group. Am J Obstet Gynecol 175:326–333

    Article  PubMed  CAS  Google Scholar 

  17. Kleeman S, Vassallo B, Segal J, Hungler M, Karram M (2006) The ability of history and a negative cough stress test to detect occult stress incontinence in patients undergoing surgical repair of advanced pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17:27–29

    Article  PubMed  Google Scholar 

  18. Reena C, Kekre AN, Kekre N (2007) Occult stress incontinence in women with pelvic organ prolapse. Int J Gynaecol Obstet 97:31–34

    Article  PubMed  CAS  Google Scholar 

  19. Visco AG, Brubaker L, Nygaard I, Richter HE, Cundiff G, Fine P, Zyczynski H, Brown MB, Weber AM (2008) 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 19:607–614

    Article  PubMed  Google Scholar 

  20. Karram MM (1999) What is the optimal anti-incontinence procedure in women with advanced prolapse and ‘potential’ stress incontinence? Int Urogynecol J Pelvic Floor Dysfunct 10:1–2

    Article  PubMed  CAS  Google Scholar 

  21. Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL (2004) Patient satisfaction and changes in prolapse and urinary symptoms in women who were fitted successfully with a pessary for pelvic organ prolapse. Am J Obstet Gynecol 190:1025–1029

    Article  PubMed  Google Scholar 

  22. Brubaker L, Cundiff GW, Fine P, Nygaard I, Richter HE, Visco AG, Zyczynski H, Brown MB, Weber AM (2006) Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med 354:1557–1566

    Article  PubMed  CAS  Google Scholar 

  23. Brubaker L, Nygaard I, Richter HE, Visco A, Weber AM, Cundiff GW, Fine P, Ghetti C, Brown MB (2008) Two-year outcomes after sacrocolpopexy with and without Burch to prevent stress urinary incontinence. Obstet Gynecol 112:49–55

    PubMed  Google Scholar 

  24. Burgio KL, Nygaard IE, Richter HE, Brubaker L, Gutman RE, Leng W, Wei J, Weber AM (2007) Bladder symptoms 1 year after abdominal sacrocolpopexy with and without Burch colposuspension in women without preoperative stress incontinence symptoms. Am J Obstet Gynecol 197:647–646

    Article  PubMed  Google Scholar 

  25. Gadonneix P, Ercoli A, Salet-Lizee D, Cotelle O, Bolner B, Van Den AM, Villet R (2004) Laparoscopic sacrocolpopexy with two separate meshes along the anterior and posterior vaginal walls for multicompartment pelvic organ prolapse. J Am Assoc Gynecol Laparosc 11:29–35

    Article  PubMed  Google Scholar 

  26. Antiphon P, Elard S, Benyoussef A, Fofana M, Yiou R, Gettman M, Hoznek A, Vordos D, Chopin DK, Abbou CC (2004) Laparoscopic promontory sacral colpopexy: is the posterior, recto-vaginal, mesh mandatory? Eur Urol 45:655–661

    Article  PubMed  CAS  Google Scholar 

  27. Costantini E, Zucchi A, Giannantoni A, Mearini L, Bini V, Porena M (2007) Must colposuspension be associated with sacropexy to prevent postoperative urinary incontinence? Eur Urol 51:788–794

    Article  PubMed  Google Scholar 

  28. Wille S, Braun M, Heidenreich A, Hofmann R, Engelmann U (2006) Sacral colpopexy with concurrent Burch colposuspension in patients with vaginal vault prolapse. Urol Int 76:339–344

    Article  PubMed  CAS  Google Scholar 

  29. Misrai V, Roupret M, Cour F, Chartier-Kastler E, Richard F (2008) De novo urinary stress incontinence after laparoscopic sacral colpopexy. BJU Int 101:594–597

    Article  PubMed  Google Scholar 

  30. Meschia M, Pifarotti P, Spennacchio M, Buonaguidi A, Gattei U, Somigliana E (2004) A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence. Am J Obstet Gynecol 190:609–613

    Article  PubMed  Google Scholar 

  31. Hiltunen R, Nieminen K, Takala T, Heiskanen E, Merikari M, Niemi K, Heinonen PK (2007) Low-weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol 110:455–462

    PubMed  Google Scholar 

  32. Borstad E, Skrede M, Rud T (1991) Failure to predict and attempts to explain urinary stress incontinence following vaginal repair in continent women by using a modified lateral urethrocystography. Acta Obstet Gynecol Scand 70:501–506

    Article  PubMed  CAS  Google Scholar 

  33. deTayrac R, Gervaise A, Chauveaud-Lambling A, Fernandez H (2004) Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: a retrospective case-control study with short-term follow-up. Acta Obstet Gynecol Scand 83:950–954

    Article  Google Scholar 

  34. Liang CC, Chang YL, Chang SD, Lo TS, Soong YK (2004) Pessary test to predict postoperative urinary incontinence in women undergoing hysterectomy for prolapse. Obstet Gynecol 104:795–800

    PubMed  Google Scholar 

  35. Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72–77

    Article  PubMed  Google Scholar 

  36. Alcalay M, Monga A, Stanton SL (1995) Burch colposuspension: a 10–20 year follow up. Br J Obstet Gynaecol 102:740–745

    PubMed  CAS  Google Scholar 

  37. Dunn JS Jr, Bent AE, Ellerkman RM, Nihira MA, Melick CF (2004) Voiding dysfunction after surgery for stress incontinence: literature review and survey results. Int Urogynecol J Pelvic Floor Dysfunct 15:25–31

    Article  PubMed  Google Scholar 

  38. Demirci F, Yucel O, Eren S, Alkan A, Demirci E, Yildirim U (2001) Long-term results of Burch colposuspension. Gynecol Obstet Invest 51:243–247

    Article  PubMed  CAS  Google Scholar 

  39. Langer R, Lipshitz Y, Halperin R, Pansky M, Bukovsky I, Sherman D (2001) Long-term (10–15 years) follow-up after Burch colposuspension for urinary stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 12:323–326

    Article  PubMed  CAS  Google Scholar 

  40. Karram MM, Segal JL, Vassallo BJ, Kleeman SD (2003) Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol 101:929–932

    Article  PubMed  Google Scholar 

  41. Barnes NM, Dmochowski RR, Park R, Nitti VW (2002) Pubovaginal sling and pelvic prolapse repair in women with occult stress urinary incontinence: effect on postoperative emptying and voiding symptoms. Urology 59:856–860

    Article  PubMed  Google Scholar 

  42. Cosson M, Boukerrou M, Narducci F, Occelli B, Querleu D, Crepin G (2003) Long-term results of the Burch procedure combined with abdominal sacrocolpopexy for treatment of vault prolapse. Int Urogynecol J Pelvic Floor Dysfunct 14:104–107

    Article  PubMed  CAS  Google Scholar 

  43. Roovers JP, Oelke M (2007) Clinical relevance of urodynamic investigation tests prior to surgical correction of genital prolapse: a literature review. Int Urogynecol J Pelvic Floor Dysfunct 18:455–460

    Article  PubMed  Google Scholar 

  44. Roovers JP, van Laar JO, Loffeld C, Bremer GL, Mol BW, Bongers MY (2007) Does urodynamic investigation improve outcome in patients undergoing prolapse surgery? Neurourol Urodyn 26:170–175

    Article  PubMed  CAS  Google Scholar 

  45. Bemelmans BL (2006) Re: abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. Eur Urol 50:381

    Article  PubMed  Google Scholar 

  46. Brubaker L, Cundiff G, Fine P, Nygaard I, Richter H, Visco A, Zyczynski H, Brown MB, Weber A (2003) A randomized trial of colpopexy and urinary reduction efforts (CARE): design and methods. Control Clin Trials 24:629–642

    Article  PubMed  CAS  Google Scholar 

  47. Colombo M, Maggioni A, Zanetta G, Vignali M, Milani R (1996) Prevention of postoperative urinary stress incontinence after surgery for genitourinary prolapse. Obstet Gynecol 87:266–271

    Article  PubMed  CAS  Google Scholar 

  48. Klutke JJ, Ramos S (2000) Urodynamic outcome after surgery for severe prolapse and potential stress incontinence. Am J Obstet Gynecol 182:1378–1381

    Article  PubMed  CAS  Google Scholar 

  49. Groutz A, Gordon D, Wolman I, Jaffa AJ, Kupferminc MJ, David MP, Lessing JB (2000) The use of prophylactic Stamey bladder neck suspension to prevent post-operative stress urinary incontinence in clinically continent women undergoing genitourinary prolapse repair. Neurourol Urodyn 19:671–676

    Article  PubMed  CAS  Google Scholar 

  50. Yamada T, Ichiyanagi N, Kamata S, Sakai Y, Nagahama K, Tanizawa A, Watanabe T, Horiuchi S, Saitoh H (2001) Need for sling surgery in patients with large cystoceles and masked stress urinary incontinence. Int J Urol 8:599–603

    Article  PubMed  CAS  Google Scholar 

  51. Gordon D, Gold RS, Pauzner D, Lessing JB, Groutz A (2001) Combined genitourinary prolapse repair and prophylactic tension-free vaginal tape in women with severe prolapse and occult stress urinary incontinence: preliminary results. Urology 58:547–550

    Article  PubMed  CAS  Google Scholar 

  52. Groutz A, Gold R, Pauzner D, Lessing JB, Gordon D (2004) Tension-free vaginal tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: a prospective study of 100 consecutive cases. Neurourol Urodyn 23:632–635

    Article  PubMed  Google Scholar 

  53. Clemons JL, Aguilar VC, Sokol ER, Sung VW, Myers DL (2005) Suburethral sling treatment of occult stress incontinence and intrinsic sphincter deficiency in women with severe vaginal prolapse of the anterior vs posterior/apical compartment. Am J Obstet Gynecol 192:1566–1572

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Urogynecology Unit, Department of Gynecology and Obstetrics, Maternite Hôtel-Dieu, Bd Leon Malfreyt, 63058, Clermont-Ferrand, France

    B. Fatton

Authors
  1. B. Fatton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Fatton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fatton, B. Is there any evidence to advocate SUI prevention in continent women undergoing prolapse repair? An overview. Int Urogynecol J 20, 235–245 (2009). https://doi.org/10.1007/s00192-008-0734-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-008-0734-4

Keywords

Search

Navigation