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March 2007 · Vol. 19, No. 03

PELVIC SURGERY CONTROVERSIES

Treating the range of lower-tract symptoms in prolapse

Does prolapse correlate with lower urinary-tract symptoms? What are the testing and treatment options for those symptoms?


Fast Track

If voiding improves when prolapse is reduced, the prolapse is probably causing urethral obstruction

Before repairing an advanced degree of prolapse, identify any urethral obstruction or occult sphincteric incontinence

Jerry  G.  Blaivas,  MD

Clinical Professor of Urology, Weill Medical College of Cornell University, and Attending Surgeon, New York Presbyterian Hospital, Lenox Hill Hospital, New York, NY

Mickey  M.  Karram,  MD

Director of Urogynecology, Good Samaritan Hospital, and Professor of Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, Ohio

Lower urinary tract symptoms are common in women who have pelvic organ prolapse (POP). For some, these symptoms resolve or improve after surgery for prolapse; for others, symptoms remain unchanged or become worse. These clinical pearls can help you decide how to counsel, evaluate, and treat patients who have POP and coexisting lower-tract symptoms.

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