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Vaginal Bulge Surgery Fails in One in Four Women in Study

The most robust surgery currently performed to treat pelvic organ prolapse, in which the uterus or vaginal walls bulge into the vagina, provides only temporary relief for many women, a study found.

The results published in the Journal of the American Medical Association provide the longest look at how the 225,000 women who undergo surgery annually may fare in subsequent years. The surgery failed in one-quarter of women, with a renewed bulge or symptoms returning within seven years, the researchers said.

Most women were better off after the surgery in terms of how much prolapse they had, said Ingrid Nygaard, a professor of obstetrics and gynecology at the University of Utah School of Medicine in Salt Lake City. Still, women need to be aware of the risks and how long the benefits may last, she said.

“The surgery that is considered to be the most durable and effective for pelvic organ prolapse fails to restore normal anatomy in one out of four women,” Nygaard said in a telephone interview. “We were interested in not only how women felt, but if surgery was doing what it was designed to do, which is hold the vagina up.”

When researchers took into account the return of prolapse symptoms and a renewed bulge, the surgery failed in 48 percent of women after seven years. Incontinence developed in 81 percent of those who didn’t get another procedure to prevent it and 75 percent of those who did.

The study didn’t involve the vaginal mesh implants that the U.S. Food and Drug Administration said were potentially dangerous and needed more study. The agency last year ordered Johnson & Johnson, C.R. Bard Inc. and 31 other manufacturers to collect as much as three years of data on the safety of their products after a report found a fivefold increase in deaths, injuries and malfunctions linked to some products.

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