title: The use of the pessary test in preoperative assessment of women with severe genital prolapse.
abstract: OBJECTIVE
  To investigate whether a preoperative pessary test could be used to identify patients with occult stress incontinence and if simultaneous anti-incontinence surgery with a midurethral sling could prevent postoperative incontinence.
  
  
  METHODS
  Eighty-two patients with a positive pessary test and severe genital prolapse participated in the study: 43 patients underwent prolapse surgery and transobturator tension-free vaginal tape (TVT-O) insertion and 39 patients underwent prolapse surgery only.
  
  
  RESULTS
  The objective cure rate for TVT-O and prolapse surgery was 90.7% at three months follow up and 88.4% at two years follow up. The objective cure rate for prolapse surgery only was 74.4% at three months and 58.9% at two years follow up.
  
  
  CONCLUSIONS
  The pessary test can be used preoperatively in patients with significant genitourinary prolapse to identify those with occult stress urinary incontinence. The TVT-O procedure in this context could be a useful optional procedure as it appears to be very effective and safe in patients with occult stress incontinence.
authors.affiliation: Department of Urogynaecology and Pelvic Floor Disorders, Aretaieion Hospital, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Liapis
authors.forename: P
authors.initials: P
authors.lastname: Bakas
authors.forename: C
authors.initials: C
authors.lastname: Georgantopoulou
authors.forename: G
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000601:surgery; D010812:Physical Stimulation / Q000295:instrumentation; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012720:Severity of Illness Index; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014621:Vagina