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Two Duke Ob/Gyn Urogynecology Studies Published in JAMA

Wednesday, September 18, 2019

Two Pelvic Floor Disorders Network (PFDN) studies conducted at Duke University  (a national PFDN research site) have been published in the September issue of the Journal of the American Medical Association. Faculty in the Duke School of Medicine's Department of Obstetrics and Gynecology, Alison Weidner, MD, MMCI, and Anthony Visco, MD, co-authored the two studies, Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM), and SUPeR: Study of Uterine Prolapse Procedures- Randomized Trial, respectively. Both studies researched patient outcomes in Female Pelvic Medicine and Reconstructive Surgery (Urogynecology).

ESTEEM: The study notes that surgery for stress urinary incontinence (leaking that occurs with a cough or sneeze) improves symptoms of another form of incontinence, called urgency urinary incontinence, in women who have both types

"This is a great opportunity to highlight high quality research via randomized trials answering important questions in women's healthcare," said ESTEEM co-author Dr. Alison Weidner.

Dr. Weidner and colleagues' research found that one year after treatment, both groups had significant improvements in both types of urinary incontinence symptoms, measured using a questionnaire. Incontinence symptoms were slightly better in the combined group, but did not differ greatly from the sling only group.

SUPeR: Two surgical procedures used to correct vaginal prolapse—one to remove the uterus and one that supports the uterus with mesh—have comparable three-year outcomes, according to the SUPeR study. To date, the randomized clinical trial provides the longest-term comparison of the procedures, and researchers will continue to follow the patients for a total of five years. The study was designed to compare effectiveness/adverse events of the two strategies.

Dr. Anthony Visco, Division Chief of Female Pelvic Medicine and Reconstructive Surgery at Duke, was a co-author of the study, findings from which did not show significantly lower rate of the composite prolapse outcome after three years (noting that further research is needed to assess whether vaginal mesh hysteropexy is more effective than vaginal hysterectomy with uterosacral ligament suspension).

About the PFDN
The PFDN includes eight clinical centers and a data coordinating center (DCC) located at U.S. universities and medical centers. Leadership at each clinical center is provided by a Principal Investigator (PI), who is a practicing physician with substantial experience in treating PFDs. A research coordinator oversees the progress of PFDN's clinical trials under the supervision of the PI and a multidisciplinary team. PFDN members work together to develop and perform research studies related to women with pelvic floor disorders. The PFDN  was started to study pelvic floor problems and come up with answers to these questions.

Sources:

Pelvic Floor Disorders Network
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institutes of Health (NIH)
Journal of the American Medical Association