Uro-genital prolapse surgery: update on post-operative urinary incontinence

Uro-genital prolapse, also called pelvic organ prolapse (POP), is the downward descent of the pelvic organs (bladder, uterus and rectum) that results in their protrusion through the vagina. The disorder can affect the anterior as well as the posterior vaginal wall, the uterus or the apex of the vagina, usually in some combination. At the end of the 1990s, more than 225,000 inpatient surgical procedures for POP had been undertaken in the US, with a reported incidence of 22.7 surgeries per 10,000 women.1 The cost of POP surgery in that country is estimated at more than US$1billion, and similar figures can be observed in other developed countries.2 POP is the leading indication for hysterectomy in post-menopausal women and accounts for 15–18% of procedures in all age groups.3 Surgery for POP is safe and effective, and rarely results in mortality or severe morbidity. However, it may cause symptoms of the lower genital, urinary and gastrointestinal tracts that can affect a woman’s daily activities and quality of life.