Women who undergo surgery to correct pelvic organ prolapse - a condition in which the vagina and nearby organs lose support and fall out of position - often find that the surgery comes with a bothersome tradeoff: urinary stress incontinence.
However, the lead article in the New England Journal of Medicine reports that by adding a bladder-supporting procedure known as Burch colposuspension to the operation, women who had not been bothered by stress incontinence before the procedure were much less likely to have this problem after their prolapse surgery. More than 200,000 American women undergo surgery to correct prolapse each year. Stress incontinence refers to the leaking of small amounts of urine during coughing, laughing or exercise. A total of 322 women were studied in nine centers across the United States.
"We found that without the Burch procedure, one in every four women developed some stress incontinence that they considered bothersome. We were able to reduce this to one in every 20 women by adding the four stitches of the Burch procedure," said principal investigator Linda Brubaker, MD, director of the Women's Pelvic Medicine Center, Loyola University Health System, Maywood, Ill.