Female incontinence can be treated effectively by either of two surgeries, a new study suggests.
The condition, known as pelvic organ prolapse, is best treated by one of two different surgeries - sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (ULS). Up until now, however, no data has been available to indicate which one is the safer or more effective option, typically leading surgeons to weigh up unknown benefits. Results of the study, however, suggest that both are equally efficient at repairing incontinence, demonstrating that neither method has any real edge over its competitor.
Titled Comparison of 2 Transvaginal Surgical Approaches and Perioperative Behavioral Therapy for Apical Vaginal Prolapse, the study was published in the Journal of the American Medical Association and found that the success rates bore little difference - SSLF with 60.5 percent and ULS with a 59.2 percent success rate. As a result, the study's author, Dr. Matthew D. Barber, recommends that surgeons continue to do the procedure they're most comfortable with. The procedures both entail attaching the top of the vagina to ligaments in the pelvic cavity region, essentially shifting the vagina back into place.
The study looked at women who had undergone either surgery two years prior, observing their recovery and the outcome of the procedure. Each of the participants suffered from stages 2, 3, or 4 of vaginal prolapse. The SSLF group comprised of 152 women; the ULS group, of 157. With comparable degrees of post-op pain and recuperation times, both procedures are also thought to be on equal footing in terms of cost and recovery.
Another key finding of the study was that perioperative pelvic floor training (BPMT) did little to ease symptoms. That held true for symptoms experienced six months following surgery, as well as at the two-year follow-up point. However, Barber isn't dismissing the technique altogether, advising that it still has its place in less severe cases of female incontinence. "Behavioral therapy and pelvic muscle exercises are good standalone treatments for incontinence outside surgery and should still be considered first-line treatment," he said to Medpage Today.
His findings were supported by Dr. Kathy Connell of the University of Colorado School of Medicine in Aurora, who was not involved with the study. "The fact that they didn't really see much change with the pelvic floor therapy is just that we're catching these women so much later in life," said Connell. "We really need to intervene at much younger stages."
