Evaluation of Treatment Options for Pelvic Organ Prolapse

Many women with pelvic prolapse have questions about long-term expectations when choosing between surgery or pessary.

Pelvic organ prolapse affects millions of women. It occurs when the pelvic organs drop from their normal position in the pelvis. This can have a negative impact on a woman's overall functioning and quality of life.

Two of the most common treatments are surgery or pessary, which is a removable device that helps provide support to the pelvic organs. While both surgery and pessary can improve prolapse symptoms, questions remain about patients' functional outcomes and goal attainment between the two forms of treatment.

Cause of Pelvic Organ Prolapse Identified
The cause of pelvic organ prolapse is due to the combination of a loss of elasticity and breakdown of proteins that are present in the vaginal wall, says a gynecologist.

‘While women undergoing surgery or having a pessary achieve their goals and have improvements in physical, social and emotional functioning, those who underwent surgery experienced greater improvements.’

Research on this topic has been published in the American Journal of Obstetrics & Gynecology.

The research was conducted by Vivian W. Sung, Kyle J. Wohlrab and Annetta Madsen, MD (fellow) of the Division of Urogynecology and Reconstructive Pelvic Surgery at Women & Infants Hospital of Rhode Island, a Care New England Hospital, and The Warren Alpert Medical School of Brown University, as well as Christina Raker of the Division of Research at Women & Infants Hospital and the Alpert Medical School.

The researchers found that while women undergoing surgery or having a pessary achieve their goals and have improvements in physical, social and emotional functioning, those who underwent surgery experienced greater improvements.

Vaginal Delivery Increases Pelvic Organ Prolapse Risk
A recent study finds that women who give birth vaginally are at a higher risk of developing pelvic organ prolapse.

"When choosing between surgery or pessary, many women have questions about long-term expectations," explained Dr. Sung. "While we already know that both surgery and pessary can improve symptoms of pelvic organ prolapse, we wanted to be able to provide women with more information comparing outcomes that matter to them, such as whether they are likely to achieve their prolapse, bladder and bowel symptom goals, as well as physical, social, emotional and sexual functioning goals."

A total of 160 women were enrolled in the study and followed for up to 12 months, including 72 surgical and 64 pessary patients.

Surgery for Pelvic Organ Prolapse is Effective Long-term
After seven years of follow-up, results suggest that women considering abdominal sacrocolpopexy (surgery for pelvic organ prolapse [POP]) should be counseled that this procedure effectively provides relief from POP symptoms.

Dr. Sung and her team concluded, "At follow-up, a higher proportion of women in the surgery group reported successfully achieving symptom goals and function goals compared with women who chose pessary." However, the team also acknowledged that not all women desire surgical treatment and women who continued with pessary also experienced improvements in symptoms.

Source-Eurekalert

Long-Term Success Rates in Pelvic Organ Prolapse Surgeries Lower Than Expected
The long term success rates achieved through surgery in treating pelvic organ prolapse are lower than previously thought.