Help for urinary leakage

April 14, 2006|By RONALD KOTULAK | RONALD KOTULAK,CHICAGO TRIBUNE

CHICAGO -- Urinary stress incontinence, a common complication for women after undergoing surgery to correct pelvic organ prolapse, can be reduced by 80 percent with a simple procedure, Loyola University Health System researchers have found.

An estimated 200,000 American women annually have surgery to correct prolapse, a condition in which supporting structures weaken, allowing the vagina and surrounding organs to fall out of position.

Other studies suggest that after the surgery, up to 60 percent of patients experience urinary stress incontinence, which involves urine leakage during laughter, coughing or exercise.

"This is the first time we have had a procedure that can prevent this type of incontinence," said lead investigator Dr. Linda Brubaker, director of Loyola's Women's Pelvic Medicine Center.

The study appeared in yesterday's issue of the New England Journal of Medicine.

The simple procedure involves four stitches that provide the bladder with independent support. It is performed in conjunction with surgery to reposition the vagina and other organs. The supporting stitches relieve pressure on the bladder's urinary opening, or sphincter, reducing the risk of leakage.

Among women who underwent the procedure, one out of 20 experienced bothersome urinary stress incontinence, compared with one out of every four women who did not undergo the procedure.

The study, which was funded by the National Institutes of Health, was stopped early because the benefits were so clear. It involved 322 women at nine medical centers in the United States. Half were randomly selected for the simple procedure, called the Burch colposuspension, and the other half underwent routine surgery for pelvic organ prolapse.

The technique is named for Dr. John Burch, a Tennessee obstetrician who pioneered it in the 1960s. In an editorial, Dr. Rebecca Rogers, a gynecologist at the University of New Mexico, writes "this study provides solid data" to justify adding the Burch procedure with prolapse surgery.

Ronald Kotulak writes for the Chicago Tribune.

The Associated Press contributed to this article.

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