Literature DB >> 19543676

Conservative versus surgical management of prolapse: what dictates patient choice?

Dharmesh S Kapoor1, Ranee Thakar, Abdul H Sultan, Reeba Oliver.   

Abstract

INTRODUCTION AND HYPOTHESIS: The aim of this study is to establish whether the presence of severe symptoms influences women's choice of pessaries or surgery for uterovaginal prolapse.
METHODS: This is a prospective study using the validated Sheffield Prolapse Symptoms Questionnaire.
RESULTS: Women choosing surgery (n = 251) were younger (58 versus 66 years), more bothered by dragging lower abdominal pain (33% versus 25%, P = 0.04), need for vaginal digitation (8% versus 3%, P = 0.02), and incomplete bowel emptying (27% versus 19%, P = 0.01) than women choosing pessaries (n = 429). More women opting for surgery were sexually active (51% versus 29%, P < 0.0001), perceived avoidance of sex due to prolapse (28% versus 17%, P = 0.000), and perceived prolapse interfering with sexual satisfaction as a severe problem (26% versus 15%, P = 0.000).
CONCLUSIONS: Nearly two thirds of women with symptomatic prolapse initially opted for conservative management. Women choosing surgery over pessaries for treatment of prolapse describe more severe symptoms related to bowel emptying, sexual function, and quality of life and are bothered by them.

Entities:  

Mesh:

Year:  2009        PMID: 19543676     DOI: 10.1007/s00192-009-0930-x

Source DB:  PubMed          Journal:  Int Urogynecol J Pelvic Floor Dysfunct


  27 in total

1.  Gynecologists' patterns of prescribing pessaries.

Authors:  E Pott-Grinstein; J R Newcomer
Journal:  J Reprod Med       Date:  2001-03       Impact factor: 0.142

2.  Rectocele repair: a randomized trial of three surgical techniques including graft augmentation.

Authors:  Marie Fidela R Paraiso; Matthew D Barber; Tristi W Muir; Mark D Walters
Journal:  Am J Obstet Gynecol       Date:  2006-12       Impact factor: 8.661

3.  Development and psychometric testing of a symptom index for pelvic organ prolapse.

Authors:  H D Bradshaw; L Hiller; A G Farkas; S Radley; S C Radley
Journal:  J Obstet Gynaecol       Date:  2006-04       Impact factor: 1.246

4.  Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse.

Authors:  Ruwan J Fernando; Ranee Thakar; Abdul H Sultan; Sheetle M Shah; Peter W Jones
Journal:  Obstet Gynecol       Date:  2006-07       Impact factor: 7.661

5.  Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence.

Authors:  A M Weber; M D Walters; M R Piedmonte
Journal:  Am J Obstet Gynecol       Date:  2000-06       Impact factor: 8.661

6.  The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care.

Authors:  S E Swift
Journal:  Am J Obstet Gynecol       Date:  2000-08       Impact factor: 8.661

7.  Sexual function in women with uterovaginal prolapse and urinary incontinence.

Authors:  A M Weber; M D Walters; L R Schover; A Mitchinson
Journal:  Obstet Gynecol       Date:  1995-04       Impact factor: 7.661

8.  Patient-selected goals: a new perspective on surgical outcome.

Authors:  Eman A Elkadry; Kimberly S Kenton; Mary P FitzGerald; Susan Shott; Linda Brubaker
Journal:  Am J Obstet Gynecol       Date:  2003-12       Impact factor: 8.661

9.  Posterior repair and sexual function.

Authors:  Yuko M Komesu; Rebecca G Rogers; Dorothy N Kammerer-Doak; Matthew D Barber; Ambre L Olsen
Journal:  Am J Obstet Gynecol       Date:  2007-07       Impact factor: 8.661

10.  Predicting treatment choice for patients with pelvic organ prolapse.

Authors:  Michael Heit; Chris Rosenquist; Patrick Culligan; Carol Graham; Miles Murphy; Susan Shott
Journal:  Obstet Gynecol       Date:  2003-06       Impact factor: 7.661

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  24 in total

1.  Prospective evaluation of outcome of vaginal pessaries versus surgery in women with symptomatic pelvic organ prolapse.

Authors:  Zeelha Abdool; Ranee Thakar; Abdul H Sultan; Reeba S Oliver
Journal:  Int Urogynecol J       Date:  2010-12-16       Impact factor: 2.894

2.  Response to the Letter to the Editor by Waarsenburg et al.

Authors:  Farah Lone; Ranee Thakar; Abdul H Sultan
Journal:  Int Urogynecol J       Date:  2015-09       Impact factor: 2.894

Review 3.  Pessaries (mechanical devices) for pelvic organ prolapse in women.

Authors:  Carol Bugge; Elisabeth J Adams; Deepa Gopinath; Fiona Reid
Journal:  Cochrane Database Syst Rev       Date:  2013-02-28

4.  Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse: a randomized controlled trial.

Authors:  Ulla Due; Søren Brostrøm; Gunnar Lose
Journal:  Int Urogynecol J       Date:  2015-10-06       Impact factor: 2.894

5.  Symptoms, quality of life, and factors affecting women's treatment decisions regarding pelvic organ prolapse.

Authors:  Symphorosa Shing Chee Chan; Rachel Yau Kar Cheung; Ka Wah Yiu; Lai Loi Lee; Albe Wai Lam Pang; Tony Kwok Hung Chung
Journal:  Int Urogynecol J       Date:  2012-03-08       Impact factor: 2.894

Review 6.  Prolapse Repair Using Non-synthetic Material: What is the Current Standard?

Authors:  Ricardo Palmerola; Nirit Rosenblum
Journal:  Curr Urol Rep       Date:  2019-10-14       Impact factor: 3.092

7.  Natural history of pessary use in women aged 65 - 74 versus 75 years and older with pelvic organ prolapse: a 12-year study.

Authors:  Sophie Ramsay; Le Mai Tu; Cara Tannenbaum
Journal:  Int Urogynecol J       Date:  2016-02-12       Impact factor: 2.894

8.  One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires.

Authors:  Farah Lone; Ranee Thakar; Abdul H Sultan
Journal:  Int Urogynecol J       Date:  2015-04-11       Impact factor: 2.894

9.  International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain.

Authors:  Marie-Andrée Harvey; Hui Ju Chih; Roxana Geoffrion; Baharak Amir; Alka Bhide; Pawel Miotla; Peter F W M Rosier; Ifeoma Offiah; Manidip Pal; Alexandriah Nicole Alas
Journal:  Int Urogynecol J       Date:  2021-08-02       Impact factor: 2.894

10.  The pessary process: Spanish-speaking Latinas' experience.

Authors:  Claudia Sevilla; Cecilia K Wieslander; Alexandriah Alas; Gena Dunivan; Aqsa Khan; Sally Maliski; Rebecca Rogers; Jennifer T Anger
Journal:  Int Urogynecol J       Date:  2012-12-04       Impact factor: 2.894

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