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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 3/2019

Open Access 01-03-2019 | Chronic Obstructive Lung Disease | General Gynecology

Prolapse surgery versus vaginal pessary in women with symptomatic pelvic organ prolapse: which factors influence the choice of treatment?

Authors: Barbara Bodner-Adler, Klaus Bodner, Anna Stinglmeier, Oliver Kimberger, Ksenia Halpern, Heinz Koelbl, Wolfgang Umek

Published in: Archives of Gynecology and Obstetrics | Issue 3/2019

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Abstract

Objective

To investigate which specific clinical factors influence patients’ choice of prolapse treatment.

Methods

This study includes a total of 510 cases with symptomatic pelvic organ prolapse (POP) of stage II or higher requiring prolapse treatment. Patients were divided into surgery and pessary groups according to their own choice and treatment preference. Primary outcome of interest was to define potential clinical parameters, which contribute to surgical treatment decision.

Results

A total of 252/510 (49%) women decided for prolapse surgery and 258/510 (51%) cases were treated conservatively with vaginal pessary. Hypertension, COPD as well as polypharmacy were parameters, which were statistically significantly more common in the pessary group compared to the surgically managed cases (p <0.05). On the contrary, women undergoing prolapse surgery were significantly younger and showed more advanced POP-Q (pelvic organ prolapse quantification) stages (p < 0.05). Clinical factors, such as BMI (body mass index), parity, mode of delivery and postmenopausal status, did not differ between the two groups (p > 0.05). Multiple logistic regression analysis revealed that advanced POP-Q stage (p < 0.001) as well as the absence of smoking (p < 0.001) were independent factors associated with surgical treatment decision.

Conclusion

Women, who favoured prolapse surgery, were younger and in significant better health condition (less hypertension and COPD), but showed a significantly higher POP-Q stage compared to women choosing pessary treatment. Our data indicate that women with higher POP-Q stage and non-smokers tended to decide for prolapse surgery. This information could help in clinical practice to guide patients for the best possible treatment decision and strengthen individual counselling.
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Metadata
Title
Prolapse surgery versus vaginal pessary in women with symptomatic pelvic organ prolapse: which factors influence the choice of treatment?
Authors
Barbara Bodner-Adler
Klaus Bodner
Anna Stinglmeier
Oliver Kimberger
Ksenia Halpern
Heinz Koelbl
Wolfgang Umek
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 3/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05046-7

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