Summary: 2017 international consultation on incontinence evidence-based surgical pathway for pelvic organ prolapse

Christopher F. Maher*, Kaven K. Baessler, Matthew D. Barber, Cecilia Cheon, Esther C.J. Consten, Kevin G. Cooper, Xavier Deffieux, Viviane Dietz, Robert E. Gutman, Jan J. Van Iersel, Charles W. Nager, Vivian W. Sung, Renaud De Tayrac

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    7 Citations (Scopus)

    Abstract

    Objective The aim of this article is to summarize the relevant findings that inform the 2017 International Consultation on Incontinence pathway for surgical treatment of pelvic organ prolapse (POP). Methods We conducted an evidence-based review of the English-language peer-reviewed literature relating to POP surgery published prior to December 2016. Level 1 evidence (randomized controlled trials [RCTs] or systematic reviews of RCTs) was preferred; however, level 2 (poor-quality RCT, prospective cohort studies) or 3 evidence (case series or retrospective studies) has been included if level 1 data were lacking. The committee evaluated the literature and made recommendations based on the Oxford grading system summarized as follows: grade A recommendation usually depends on consistent level 1 evidence; grade B recommendation usually depends on consistent level 2 and/or 3 studies, or "majority evidence" from RCTs; grade C recommendation usually depends on level 3 studies or "majority evidence" from level 2/3 studies or Delphi-processed expert opinion; grade D, "no recommendation possible," would be used where the evidence is inadequate or conflicting. Results The recommendations from each chapter of the review are presented and serve to inform an evidence-based pathway for the surgical treatment of prolapse. A Web-based interactive application of the pathway is presented. Conclusions The 2017 International Consultation on Incontinence pathway on surgery for POP is designed as an adjunct to transparent consultation and consent relating to POP surgery. The final decision regarding surgical intervention can be made only after a shared decision-making process between the patient and the clinician that will evaluate a variety of individual factors that cannot be assessed in the pathway.

    Original languageEnglish
    Pages (from-to)30-36
    Number of pages7
    JournalFemale Pelvic Medicine and Reconstructive Surgery
    Volume26
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2020

    Keywords

    • pathway
    • pelvic organ prolapse
    • surgery

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