Surgery for women with pelvic organ prolapse with or without stress urinary incontinence

In women with POP and symptomatic or occult SUI, a concomitant midurethral sling probably reduces SUI, but adverse effects remain unclear. It is also feasible to postpone the midurethral sling and perform a continence procedure only if required. In continent women, a Burch colposuspension during abdominal POP surgery reduced new-onset SUI rates in one underpowered study, but another RCT reported conflicting results. Adding a midurethral sling during vaginal POP repair might prevent new-onset SUI. An anterior native tissue repair might be better than vaginal transobturator mesh for preventing new SUI; however, POP recurrence may be more common with native tissue repair.