Applying Internal Stitches To Support Vagina, Other Internal Organs Reduces Incontinence In Women After Surgery, Study Says

A procedure that applies two permanent, internal stitches from each side of the vagina to ligaments in the pelvis can help reduce incontinence by 80% in women who have had surgery to correct pelvic prolapse -- a condition that occurs when the pelvic organs weaken and drop into or through the vaginal opening -- according to a study published in the April 13 issue of the New England Journal of Medicine, the Chicago Tribune reports. About 200,000 women in the U.S. annually undergo surgery to correct pelvic prolapse, after which up to 60% of the women experience "urinary stress incontinence," which can be caused by laughing, coughing, exercising or other actions, according to the Tribune (Kotulak, Chicago Tribune, 4/13). Linda Brubaker, an OB/GYN professor at Loyola University, and colleagues enrolled 322 women in the study, which was funded by NIH (Marchione, AP/Houston Chronicle, 4/12). Physicians on half of the participants performed the routine surgery for pelvic prolapse, which repositions the vagina and other internal organs, in conjunction with the Burch colposuspension procedure, which applies four internal stitches to support the bladder. The other half of participants underwent only the routine surgery, the Tribune reports. The study finds that performing the additional surgery helped to alleviate the pressure on the bladder's urinary opening and decreased the risk of urinary leakage (Chicago Tribune, 4/13). According to the study, 6% of women who underwent the Burch procedure in conjunction with the routine surgery reported urinary control problems three months later, compared with 25% of the participants who did not have the additional procedure (AP/Houston Chronicle, 4/12).

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Pelvic prolapse is a "very common problem in women, and this is the first time we've been able to demonstrate that an operation can actually prevent urinary incontinence,' Brubaker said (AP/Houston Chronicle, 4/12). Despite some "limitations" in the study, including a short follow-up period, it demonstrates that performing the Burch procedure along with the routine prolapse surgery results in improved urinary control, Rebecca Rogers, an OB/GYN at the University of New Mexico, writes in a related editorial in the journal (Rogers, NEJM, 4/13).


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