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
‘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
"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.
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.