To Sling or Not to Sling?

Prophylactic midurethral sling placement at the time of vaginal prolapse repair lowered risk for de novo urinary incontinence but raised risk for surgical complications.

An estimated one in five U.S. women undergoes surgical repair for pelvic organ prolapse, and one quarter of these women develop new-onset urinary incontinence following surgery. In a government-funded, randomized, single-blind trial, women without incontinence who were having surgery for vaginal prolapse repair also received either a prophylactic midurethral sling or a sham incision.

In 327 evaluable women, the rate of urinary incontinence 12 months after surgery was 27.3% in the sling group versus 43.0% in the sham group (P=0.002). The number needed to treat with a sling to prevent one case of urinary incontinence at 12 months, allowing for subsequent treatment for incontinence, was 6.3. Prophylactic sling placement was associated with high…

Reviewing Author

Brent E. Seibel, MD

To Sling or Not to Sling?

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Reviewing Author