Transvaginal Surgery for Vaginal Prolapse: One Method Apparently Not Better Than Another — Physician’s First Watch
Transvaginal Surgery for Vaginal Prolapse: One Method Apparently Not Better Than Another
By Amy Orciari Herman
A JAMA study finds no difference in success rates between two common transvaginal surgeries for vaginal prolapse and calls into question the use of perioperative behavioral therapy to improve urinary symptoms.
Some 400 women with stage 2 through 4 apical prolapse and stress incontinence were randomized first to either perioperative behavioral therapy with pelvic floor muscle training or usual care, and then to surgery with either sacrospinous ligament fixation or uterosacral ligament vaginal vault suspension.
At 2 years, surgical success was similar in the two surgery groups, at roughly 60%. Similarly, urinary and prolapse symptoms, measured at 6 months and 2 years, respectively, did not differ between the behavioral-intervention and usual-care groups.
The researchers conclude that one surgical method is not superior to the other, and that behavioral therapy with pelvic floor muscle training "is likely unnecessary as a routine aspect of perioperative care."