Harvard Women's Health Watch

Pelvic organ prolapse surgery less effective over time

The effectiveness of surgery to correct pelvic organ prolapse (a drooping of the uterine or vaginal wall into the vaginal opening) declines over time, according to a study in the May 15 issue of The Journal of the American Medical Association. The study included about 200 women who underwent abdominal sacrocolpopexy—a procedure in which the weakened vaginal tissues are supported with mesh. About half of the women also received urethropexy, which supports the urethra to prevent incontinence. Although abdominal sacrocolpopexy relieved symptoms of pelvic organ prolapse (including pelvic pressure and bulge), during seven years of follow-up, about 10% of the women had problems with the surgical mesh. Adding urethropexy reduced the likelihood of stress incontinence, although it did not significantly affect the odds of treatment failure. The authors say that women who have surgery for pelvic organ prolapse should discuss the risks with their surgeon ahead of time.

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