Vaginal prolapse repair and mid urethral sling procedure in women with genital prolapse and predominant stress urinary incontinence.

Pelvic organ prolapse and stress urinary incontinence co-exist in about 40% of the women with genital prolapse. Because the TVT has been proven to be as successful as the Burch colposuspension in the treatment of stress incontinence, combining vaginal prolapse repair with a mid urethral sling procedure in these women has become an attractive treatment option. Concomitant surgery showed to be an effective treatment for stress urinary incontinence in observational studies. However, literature about possible adverse effects such as obstructive voiding symptoms and detrusor overactivity is not consistent. Besides, concomitant surgery will result in over treatment as the correction of a cystocele showed a 5-year success rate of 37% in the relief of stress incontinence. Thus, concomitant surgery will probably result in less postoperative complaints of stress incontinence but may lead to adverse effects and over treatment. The objective of the CUPIDO-1-trial is to determine whether vaginal prolapse repair is equally effective as concomitant vaginal surgery in women with genital prolapse and symptoms of stress urinary incontinence.

Compared to vaginal prolapse repair, concomitant vaginal surgery in women with genital prolapse and predominant stress urinary incontinence decreases the risk of postoperative urinary incontinence without increasing other lower urinary tract symptoms.

6 weeks, 6 months, 12 months.

Only vaginal prolapse repair or vaginal prolapse repair combined with mid urethral sling procedure.