Thursday, March 13, 2014

2 incontinence and prolapse procedures found to be comparable in women

MAYWOOD, Ill. – Two common procedures to treat pelvic-organ prolapse without vaginal mesh are comparable in safety and efficacy, according to research published in the March 2014 issue of the Journal of the American Medical Association. Researchers also found that behavioral and pelvic-floor-muscle therapy (BPMT) did not improve urinary incontinence or prolapse symptoms in affected women.

Pelvic-organ prolapse occurs when the uterus and/or vaginal walls protrude outside of the body. Up to 73 percent of these women report other pelvic-floor disorders such as incontinence. More than 300,000 surgeries are performed annually in the United States to correct pelvic-organ prolapse. Two common prolapse procedures evaluated in this study included uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF).

“Little has been known until now about how these procedures compare to each other,” said Linda Brubaker, MD, MS, study co-author and dean, Loyola University Chicago Stritch School of Medicine. “This study provides guidance to physicians on the benefits and risks of two widely used surgical interventions without vaginal prolapse mesh."

This study evaluated 374 women. A group of these women underwent the ULS procedure (n = 188) while the other group had the SSLF surgery (n = 186). Success rates (59.2 percent versus 60.5 percent) and adverse events (16.5 percent versus 16.7 percent) were similar two years following the surgeries. 

BPMT is an effective treatment for pelvic-floor symptoms. BPMT includes pelvic-floor-muscle training, individualized and progressive pelvic-floor-muscle exercises and education on behavioral strategies to reduce incontinence.

However, BPMT was not associated with greater improvements in incontinence symptoms at six months or prolapse at two years compared with usual care in study participants. Usual care included routine teaching and standardized post-operative instructions.

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH), on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a children's hospital, Loyola Outpatient Center, and Loyola Oral Health Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 254-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 93 hospitals, and 120 continuing care locations — including home care, hospice, PACE and senior living facilities — that provide nearly 2.5 million visits annually.