To assess the outcomes of patients with symptomatic POP and SUI who underwent a combined surgery and those with SUI repair after prior extensive PRS surgery. A comparative retrospective analysis of patients with symptomatic advanced POP, done in a tertiary referral facility. The cohort was divided into two groups: patients who received both PRS and MUS at the same time, and patients who received extensive PRS first, followed by secondary MUS, based on postoperative observations. A total of 478 patients included in the combined-surgery group and 82 were included in the two-steps group. TVM surgeries types were Perigee, Avaulta, PROLIFT, Elevate A, Uphold, Surelift, and Calistar-S. MUS procedures included Gynecare TVT, Monarc, Obtryx, KIM Miniarc, Ophira, Ajust, and Solyx. The primary endpoint was objective and subjective cure rates after one-year. Secondary outcomes included quality of life, LUTS, and surgical complications. The objective cure rate in the combined group was 90%, whereas the subjective cure rate was 89.1%. The objective and subjective cure rates in the staged group were lower: 81.7% and 79.3%, respectively. Patients in the Staged group were younger and had higher BMI. In addition, they had a higher degree of SUI, a larger rate of ISD, a higher Pad test, and worse urodynamic exam results. This study shows that combined surgery for treatment of POP and SUI is more efficient than staged one, in 12-months follow-up period. Furthermore, patients with occult SUI had better outcome than those with overt SUI.
Lo et al. (Fri,) studied this question.
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