Pelvic Organ Prolapse Surgery: Long-term Outcomes and Implications for Shared Decision Making

Pelvic floor disorders, including pelvic organ prolapse, urinary incontinence, fecal incontinence, and other sensory disorders of the gastrointestinal and genitourinary tract, are common with nearly 1 in 4 US women having at least 1 pelvic floor condition.¹ In this issue of JAMA, Nygaard and colleagues² present findings from the extended Colpopexy and Urinary Reduction Efforts (extended CARE) trial. The original CARE trial³ was a double-blind randomized trial of 322 women mostly with advanced (stage 3-4) prolapse and without stress incontinence symptoms undergoing an open abdominal synthetic mesh sacrocolpopexy procedure either with or without a urethropexy for prevention of stress urinary incontinence.