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Comment & Response
September 11, 2013

Surgery for Pelvic Organ Prolapse—Reply

Author Affiliations
  • 1University of Utah School of Medicine, Salt Lake City

Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2013;310(10):1073-1074. doi:10.1001/jama.2013.238044

In Reply Dr Fujita suggests that despite abdominal sacrocolpopexy being less effective than desired, it should still be considered a standard operation for upper vaginal prolapse. We agree. However, the fact that abdominal sacrocolpopexy is more effective than the vaginal surgeries to which it has been compared in randomized trials does not mean that it should be the initial procedure of choice for most women with apical prolapse. It is remarkable that since 1996, there have been only 5 small randomized trials (2 of them to date presented only as abstracts) comprising in total fewer than 500 women.1

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