INTRODUCTION AND HYPOTHESIS: Vaginal pessaries, pelvic floor exercises and surgery are treatment options for women with symptomatic pelvic organ prolapse (POP).
The aim of this study was to compare the outcomes of pessaries and surgery in women with symptomatic POP using the validated International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) and Urinary Incontinence (ICIQ-UI) Short Form (SF).
METHODS: Women attending the Urogynecology clinics with symptomatic POP were recruited. All women were treated using either a vaginal pessary or surgery. Outcomes were evaluated and then compared at 1 year using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires.
RESULTS: A total of 287 women with symptomatic prolapse were recruited. 269 women completed the questionnaires at baseline and 183 at 1 year. At 1 year, improvement was noted in quality of life (QOL), frequency of urinary leak and vaginal symptoms in both groups except for the symptom of vaginal soreness in the pessary group and the symptom of a tight vagina in the surgery group. However, both these symptoms were not bothersome. Women who underwent surgery demonstrated an improvement in faecal evacuation and sex life. There was an overall statistically significant improvement in vaginal, sex, QOL and urinary symptom scores in both groups. No statistically significant difference was noted between the surgery and the pessary groups.
CONCLUSIONS: Using validated questionnaires 1 year after treatment, women with symptomatic POP report improvement in vaginal, bowel, urinary and quality of life scores when treated with either pessary use or surgery. No statistically significant difference was noted in the two groups.
Written by:
Lone F, Thakar R, Sultan AH. Are you the author?
Department of Obstetrics and Gynecology, Croydon University Hospital, 530 London Road, Croydon, Surrey, CR7 7YE, UK.
Reference: Int Urogynecol J. 2015 Apr 11. Epub ahead of print.
doi: 10.1007/s00192-015-2686-9
PubMed Abstract
PMID: 25862241