Peggy Norton1, Linda Brubaker2, Charles W Nager3, Gary E Lemack4, Halina M Zyczynski5, Larry Sirls6, Leslie Rickey7, Anne Stoddard8, R Edward Varner9. 1. Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT. Electronic address: Peggy.Norton@hsc.utah.edu. 2. Department of Obstetrics and Gynecology, Loyola Stritch School of Medicine, Chicago, IL. 3. Department of Obstetrics and Gynecology, University of California at San Diego School of Medicine, La Jolla, CA. 4. Department of Urology, University of Texas Southwestern School of Medicine, Dallas, TX. 5. Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, PA. 6. Department of Urology, William Beaumont School of Medicine, Royal Oak, MI. 7. Department of Urology, Yale School of Medicine, New Haven, CT. 8. New England Research Institute, Boston, MA. 9. Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
Abstract
OBJECTIVE: The aim of our study was to observe pelvic organ prolapse (POP) over time, treated and untreated, in a group of highly characterized women being followed up subjectively and objectively over 5-7 years following continence surgery. STUDY DESIGN: We measured baseline prolapse symptoms and anatomic prolapse in subjects enrolled in the trial of midurethral sling (TOMUS) and E-TOMUS, and measured these same parameters annually for 5-7 years after the index surgery. Additional information about subsequent treatment for POP was also recorded. RESULTS: In all, 597 women were randomized to 1 of 2 midurethral sling procedures in the TOMUS; concomitant vaginal procedures for POP were allowed at the surgeon's discretion. Stage 2 POP was present at baseline in 291 subjects (49%). Symptoms of POP were reported in 67 (25%). Of the asymptomatic women, 34 of 223 (15%) underwent a concomitant POP repair at the time of index sling surgery. Anatomic progression of prolapse in women with asymptomatic, unoperated stage 2 POP over the next 72 months was infrequent and occurred in only 3 of 189 subjects (2%); none underwent surgery for POP. Most symptomatic women (47/67 [70%]) underwent a concomitant repair for POP at the index sling surgery. Three of the 47 women who had undergone concomitant repair for symptomatic stage 2 POP underwent repeat POP surgery (2 at 36 months and 1 at 48 months.) CONCLUSION: For patient populations similar to the TOMUS and E-TOMUS populations, surgeons may counsel women with asymptomatic stage 2 POP that their prolapse is unlikely to require surgery in the next 5-7 years.
OBJECTIVE: The aim of our study was to observe pelvic organ prolapse (POP) over time, treated and untreated, in a group of highly characterized women being followed up subjectively and objectively over 5-7 years following continence surgery. STUDY DESIGN: We measured baseline prolapse symptoms and anatomic prolapse in subjects enrolled in the trial of midurethral sling (TOMUS) and E-TOMUS, and measured these same parameters annually for 5-7 years after the index surgery. Additional information about subsequent treatment for POP was also recorded. RESULTS: In all, 597 women were randomized to 1 of 2 midurethral sling procedures in the TOMUS; concomitant vaginal procedures for POP were allowed at the surgeon's discretion. Stage 2 POP was present at baseline in 291 subjects (49%). Symptoms of POP were reported in 67 (25%). Of the asymptomatic women, 34 of 223 (15%) underwent a concomitant POP repair at the time of index sling surgery. Anatomic progression of prolapse in women with asymptomatic, unoperated stage 2 POP over the next 72 months was infrequent and occurred in only 3 of 189 subjects (2%); none underwent surgery for POP. Most symptomatic women (47/67 [70%]) underwent a concomitant repair for POP at the index sling surgery. Three of the 47 women who had undergone concomitant repair for symptomatic stage 2 POP underwent repeat POP surgery (2 at 36 months and 1 at 48 months.) CONCLUSION: For patient populations similar to the TOMUS and E-TOMUS populations, surgeons may counsel women with asymptomatic stage 2 POP that their prolapse is unlikely to require surgery in the next 5-7 years.
Authors: R C Bump; A Mattiasson; K Bø; L P Brubaker; J O DeLancey; P Klarskov; B L Shull; A R Smith Journal: Am J Obstet Gynecol Date: 1996-07 Impact factor: 8.661
Authors: Holly E Richter; Michael E Albo; Halina M Zyczynski; Kimberly Kenton; Peggy A Norton; Larry T Sirls; Stephen R Kraus; Toby C Chai; Gary E Lemack; Kimberly J Dandreo; R Edward Varner; Shawn Menefee; Chiara Ghetti; Linda Brubaker; Ingrid Nygaard; Salil Khandwala; Thomas A Rozanski; Harry Johnson; Joseph Schaffer; Anne M Stoddard; Robert L Holley; Charles W Nager; Pamela Moalli; Elizabeth Mueller; Amy M Arisco; Marlene Corton; Sharon Tennstedt; T Debuene Chang; E Ann Gormley; Heather J Litman Journal: N Engl J Med Date: 2010-05-17 Impact factor: 91.245
Authors: Alienor S Gilchrist; William Campbell; Hannah Steele; Hema Brazell; Jonathon Foote; Steven Swift Journal: Neurourol Urodyn Date: 2012-08-20 Impact factor: 2.696
Authors: Toby C Chai; Kimberly Kenton; Yan Xu; Larry Sirls; Halina Zyczynski; Tracey S Wilson; David D Rahn; Emily L Whitcomb; Yvonne Hsu; Elizabeth A Gormley Journal: Urology Date: 2012-04-25 Impact factor: 2.649
Authors: Michael E Albo; Heather J Litman; Holly E Richter; Gary E Lemack; Larry T Sirls; Toby C Chai; Peggy Norton; Stephen R Kraus; Halina Zyczynski; Kimberly Kenton; E Ann Gormley; John W Kusek Journal: J Urol Date: 2012-10-22 Impact factor: 7.450
Authors: Javier Pizarro-Berdichevsky; Ali Borazjani; Alejandro Pattillo; Marco Arellano; Jianbo Li; Howard B Goldman Journal: Int Urogynecol J Date: 2017-08-24 Impact factor: 2.894