Asymptomatic stage 2 pelvic organ prolapse seldom progresses

The total 575 women in TOMUS underwent either a retropubic or transobturator continence procedure. Concomitant vaginal procedures to repair pelvic organ prolapse were allowed at the surgeon’s discretion after discussion with the patient.

The women were assessed at baseline and annually for 5-7 years after surgery with the Urinary Distress Inventory (UDI) and the Pelvic Organ Prolapse Quantification System (POP-Q).

About a quarter of women with stage 2 prolapse had symptoms according to responses on the UDI. As expected, 70% of those who were symptomatic, but only 15% of those who were asymptomatic, had a concomitant repair at the time of their continence surgery.

"These findings are not generalizable to women with higher stages of prolapse since we really only had sufficient power to be looking at stage 2’s," said Dr. Norton. "Also, this was a primary randomized trial of stress incontinence, and patients were not randomized to receive or not receive concomitant prolapse repair, so it really limits our ability to [control for] selection bias or surgeon bias."

Dr. Norton disclosed no relevant financial conflicts of interest.