***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: OBJECTIVES This prospect i ve , r and omised study investigated whether a prophylactic procedure , performed during colposacropexy for prolapse repair , prevents ex novo postoperative incontinence .  Sixty-six consecutive continent patients with advanced prolapse were r and omised into two groups : group A underwent sacropexy combined with a Burch colposuspension ; no anti-incontinence procedure was performed in group B patients . METHODS Work-up included clinical assessment ( Halfway System and International Continence Society [ ICS ] classification for prolapse and Ingelman Sunderberg scale for incontinence ) , the Urogenital Distress Inventory and Impact Incontinence Quality of Life question naires , urogynaecologic ultrasound scans , and complete urodynamic testing that included the urethral pressure profile and Valsalva leak point pressure with reduced prolapse . Check-ups were done at 3 , 6 , 12 mo postoperatively and then yearly . Mean follow-up time was 39.5 mo . RESULTS The mean age ( + /- st and ard deviation ) was 62+/-9 yr . All patients presented with  grade ( G ) 3 - 4 prolapse . Postoperative incontinence was present in 12 of the 34 patients in group A : 7 G1 ; 4 G2 , and 1 G3 . Postoperative incontinence was present in 3 of the 32 patients in group B : 2 G1 , 1 G3 . The frequency of postoperative incontinence was significantly greater in patients who had undergone colposuspension ( p<0.05 ) . CONCLUSIONS These preliminary data cast doubt on whether colposuspension should be performed during sacropexy for severe urogenital prolapse as prophylaxis for postoperative incontinence because it seems to emerge as overtreatment . Incontinence developed ex novo in 35 % of continent patients treated with colposuspension combined with sacropexy Background and aims A r and omised trial was undertaken to compare the clinical and functional results of two novel transanal stapled techniques in patients with outlet obstruction syndrome . Material s and methods Ninety-six females with outlet obstruction were treated with medical therapy and biofeedback for 2 months ; 67 non-responders were evaluated by the Constipation Scoring and Continence Grading Systems , clinical examination , endoscopy , dynamic defecography , anorectal manometry , transanal ultrasound and anal EMG , and 50 of them , all affected with descending perineum , intussusception and rectocele , were r and omly assigned to two groups and operated on : 25 patients ( mean age 53.2±15.3 years ) underwent a single Stapled Trans-Anal Prolapsectomy , associated with Perineal Levatorplasty ( STAPL Group ) , and the other 25 ( mean 54.6±14.2 years ) underwent a double Stapled Trans-Anal Rectal Resection ( STARR Group ) . Patients were followed-up for a mean period of 23.4±5.1 months in STAPL Group and 22.3±4.8 in STARR Group . Results STARR Group showed a significantly ( p < 0.0001 ) lower pattern of postoperative pain and a greater decrease ( P = 0.0117 ) of the rectal sensitivity threshold volume ; otherwise , no differences were found in operative time , hospital stay , or time of inability to work . Complications included delayed healing of the perineal wound ( ten ) , dyspareunia ( five ) , urinary retention ( two ) and stenosis ( one ) in STAPL Group , and urge to defecate ( four ) , transitory incontinence to flatus ( two ) , urinary retention ( two ) , bleeding ( one ) and stenosis ( one ) in STARR Group . All constipation symptoms significantly improved without worsening of anal continence and with excellent/good outcome at 20 months in 76 and 88 % of patients of STAPL Group and STARR Group , respectively . Seven patients of STAPL Group had a little residual rectocele , while both intussusception and rectocele were corrected in all patients of STARR Group . Neither operation modified anal pressures or caused lesions of anal sphincters . Conclusions Both techniques are safe and effective in the treatment of outlet obstruction ; nevertheless , the double Stapled Trans-Anal Rectal Resection seems to be preferable due to less pain , absence of dyspareunia , reduced rectal sensitivity threshold volume and absence of residual rectocele at defecography Background : The aim of this study is to evaluate the outcome of an innovative , minimally invasive sling technique with autologous tissue in women with concomitant incontinence and anterior vaginal wall prolapse ( AVWP ) . Material s and Methods : Fifty-six women with stress urinary incontinence ( SUI ) or mixed urinary incontinence and AVWP were r and omly assigned into two groups : In Group A ( 26 patients ) , anterior colporrhaphy ( Kelly placation ) and sling placement using a strip of anterior vaginal wall were performed , and in Group B ( 30 patients ) , transvaginal mesh correction of AVWP and tension-free vaginal tape ( TVT ) insertion ( retropubic – craniocaudal route ) using polypropylene mesh were carried out . The patients were followed-up for over 18 months and were assessed objective ly using a 48 h frequency-volume chart , a 48 h pad test and a st and ardized stress test . Related surgical complications and outcomes were recorded and compared . Results : Surgical cure rates for Group A and Group B at the first ( 3 days ) and last ( 18 months ) post-operative visits were 62 % and 84 % ; and 54 % , and 72 % , respectively ( P = 0.09 and 0.31 ) . Complications occurred in 9 patients ( 44 % ) of Group B , but only 3 patients ( 12 % ) in Group A. Conclusion : Vaginal sling surgery using an anterior vaginal wall strip can improve SUI and in comparison with propylene mesh is associated with lower complication rates . Although , the surgical success rate of this technique is lower than T-Sling , larger studies with selected patients will help assess the suitable patients for this pelvic reconstructive surgery OBJECTIVE : To present the 3-year outcomes of a double-blind , multicenter , r and omized trial comparing vaginal prolapse repair with and without mesh . METHODS : This was a planned final analysis of women with Pelvic Organ Prolapse Quantification ( POP-Q ) stage 2–4 prolapse r and omized to traditional vaginal prolapse surgery without mesh and vaginal colpopexy repair with mesh .  We evaluated anatomic , symptomatic , and combined cure rates for those with at least 3-year vali date d quality -of-life question naires and 2- or 3-year postoperative blinded POP-Q examination . Participants undergoing reoperation for recurrent prolapse were removed for anatomic and subjective outcomes analysis and considered failures for combined outcomes analysis . RESULTS : Sixty-five women were enrolled ( 33 mesh , 32 no mesh ) before the study was prematurely halted as a result of a 15.6 % mesh exposure rate . At 3 years , 51 of 65 ( 78 % ) had quality -of-life question naires ( 25 mesh , 26 no mesh ) and 41 ( 63 % ) had examinations . Three participants died , three required reoperation for recurrent prolapse ( all in mesh group ) , and eight were lost to follow-up . No differences were observed between groups at 3 years for prolapse stage or individual prolapse points . Stage improved for each group ( 90 % and 86 % ) from baseline to 3 years ( P<.01 ) . Symptomatic improvement was observed with no differences in scores between groups . Cure rates did not differ between groups using a variety of definitions , and anatomic cure was lowest for the anterior compartment . CONCLUSION : There was no difference in 3-year cure rates when comparing patients undergoing traditional vaginal prolapse surgery without mesh  with those undergoing vaginal colpopexy repair with mesh .  CLINICAL TRIAL REGISTRATION : Clinical trials.gov , www . clinical trials.gov , NCT00475540 . LEVEL OF EVIDENCE : The aim of this study was to reevaluate and up date the followup of a previously published r and omized controlled trial ( RCT ) on the impact of Burch Colposuspension ( BC ) , as an anti-incontinence procedure , in patients with UI and POP , who underwent POP repair . Forty-seven women were r and omly assigned to abdominal POP repair and concomitant BC ( 24 patients ; group A ) or POP repair alone without any anti-incontinence procedure  ( 23 patients ; group B ) . Median followup was 82 months ( range 60–107 ) ; from over 47 patients , 30 reached 6-year followup . Two patients were lost at followup . In group A , 2 patients showed a stage I rectocele . In group B , 2 patients had a stage I rectocele and 1 a stage II rectocele . In group A , 13/23 ( 56.5 % ) were still incontinent after surgery compared with 9/22 patients ( 40.9 % ) in group B ( P = 0.298 ) . No significant changes were observed between the first and the current followup . The up date of long-term followup confirmed that BC did not improve outcome significantly in incontinent women when they undergo POP repair OBJECTIVE The purpose of this study was to compare 2 anti-incontinence procedures in women who had severe genital prolapse and potential stress incontinence . STUDY DESIGN In addition to vaginal reconstructive surgery , 50 patients with stage II or higher anterior defect and a positive stress test result with prolapse reduction received either tension-free vaginal tape or plication of the endopelvic fascia . Preoperative evaluation included history , physical examination , stress test , and urodynamic assessment . Data were analyzed with the Student t test , the Fisher 's exact test , and the Wilcoxon signed-rank test . RESULTS The median follow-up time was similar for both groups , 26 and 24 months . Subjective ( 96 % vs 64 % ; P=.01 ) and objective ( 92 % vs 56 % ; P<.01 ) continence rates were higher after the tension-free vaginal tape procedure . Time for the resumption of spontaneous voiding , rates of urinary retention , or de novo urge incontinence were similar in the 2 groups . CONCLUSION Tension-free vaginal tape can be recommended for patients with prolapse and occult stress incontinence AIMS With respect to urogenital function , vaginal hysterectomy combined with anterior and /or posterior colporraphy has been shown to be superior to abdominal sacrocolpopexy with preservation of the uterus . We performed a r and omized trial to compare the effects of both procedures on pain , quality of life and physical performance during the first six weeks after surgery . METHODS Eighty-two patients were r and omized to have surgery either by vaginal or abdominal approach . All patients were asked to complete the R AND -36 before surgery and 6 weeks after surgery and to keep a diary for the first 6 weeks after surgery . This diary assessed the pain perception and use of pain medication , bother of limitations due to the surgery and performance of daily activities after surgery . These outcomes were compared . RESULTS All patients completed the R AND -36 and 68 patients completed the diary . Patients who had undergone abdominal surgery had a statistically lower score on the health change domain ( 56 vs 68 ) , bodily pain domain ( 63 vs 80 ) and mental health domain ( 74 vs 81 ) of the R AND -36 , as compared to patients who had undergone vaginal prolapse surgery . During hospital stay , the abdominal group experienced on average more days of pain ( 4.5 vs 3.0 ) and impaired mobility ( 3.7 vs 2.9 ) as compared to the vaginal group . Patients received more pain medication following abdominal surgery as compared to vaginal surgery . CONCLUSIONS The vaginal operation to correct a descensus uteri is associated with less pain , better quality of life and better mobility during the first 6 weeks of the recovery period as compared to the abdominal approach The aim of this study was to compare the efficiency of polypropylene mesh surgery with the site-specific repair surgeries in the treatment of cystocoeles . We r and omized 90 patients into two groups according to a computer-based program . After a 12-month ( mean ) follow up , we noticed that the polypropylene mesh surgery yielded good anatomical results . Acceptable anatomical cure rates were 91 and 72 % in the mesh surgery group and site-specific surgery group , respectively . There were three cases ( 6.9 % ) of mesh erosion . One case of urinary retention and two cases of de novo dyspareunia were seen in the mesh surgery  group . De novo stress urinary incontinence developed in three patients in the site-specific surgery group . We concluded that surgery with light polypropylene mesh ( Sofradim ® , Parietene ) is superior to the site-specific surgery in the treatment of cystocoeles We compared safety and efficacy of Gynemesh PS ® and Pelvicol ® for recurrent cystocele repair . One hundred ninety patients were r and omly divided into Gynemesh PS ® and Pelvicol ® groups and underwent tension-free cystocele repair . The Chi-square test was used to compare categorical variables , the paired t test for continuous parametric variables , and the Mann – Whitney test for continuous nonparametric variables . Ninety-six Gynemesh PS ® patients and 94 Pelvicol ® patients were studied . 
    Output:
    
Adding an MUS during vaginal POP repair might reduce postoperative development of SUI.An anterior native tissue repair might be better than use of transobturator mesh for preventing postoperative SUI ; however , prolapse recurrence is more common with native tissue repair