title: Does concomitant prolapse repair at the time of midurethral sling affect recurrent rates of incontinence?
abstract: OBJECTIVE
  We compared outcomes after midurethral sling (MUS) with and without concomitant repair for prolapse.
  
  
  METHODS
  Women who underwent MUS with or without concomitant repair for prolapse completed a follow-up survey. Outcomes were assessed with validated questionnaires and medical record review. Kaplan-Meier, Cox proportional hazards regression, and logistic regression models were used for analysis.
  
  
  RESULTS
  Of 317 women, 281 (89%) responded to the survey. During a median follow-up of 2.7 years, survival free of "any" incontinence (Incontinence Severity Index score, >0) was similar in both groups (adjusted hazard ratio, 1.07; P = 0.77). Women with concomitant repair for advanced prolapse tended to be more bothered by frequent urination (adjusted odds ratio, 1.78; P = 0.08) and more likely to require urethrolysis (odds ratio, 6.11; P = 0.04) than those without concomitant pelvic floor repair.
  
  
  CONCLUSIONS
  Prolapse repairs concomitant with MUS did not affect incontinence recurrence. However, repairs may cause increased lower urinary tract symptoms.
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Casiano.Elizabeth@mayo.edu
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Casiano
authors.forename: John B
authors.initials: JB
authors.lastname: Gebhart
authors.forename: Michaela E
authors.initials: ME
authors.lastname: McGree
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Klingele
authors.forename: Emanuel C
authors.initials: EC
authors.lastname: Trabuco
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D016016:Proportional Hazards Models; D012008:Recurrence; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014563:Urodynamics