Do patients prefer a pessary or surgery as primary treatment for pelvic organ prolapse.

Abstract:

BACKGROUND/AIMS:To assess whether patients prefer surgery or a pessary as treatment for pelvic organ prolapse (POP). METHODS:A structured interview was performed among treated and untreated women with POP. We conducted fictive scenarios of potential disadvantages of surgery and pessary use. Our main outcome was the willingness to alter treatment preference (by increasing percentages of defined disadvantages) and determine conditions at which treatment preference changes to alternative treatment. RESULTS:Three groups of 25 patients were interviewed: (1) untreated patients, (2) patients who underwent surgery, and (3) patients treated with a pessary. In the treatment-naive group, 48% preferred surgery, 36% a pessary and 16% had no preferable treatment. Patients switched preference from surgery to a pessary at a median risk of stress urinary incontinence of 22% and of recurrent prolapse of 43%. Patients switched preference from pessary to surgery at a median risk of vaginal irritation of 32%, of placing problems of 32% and of incomplete symptom relief of 17%. CONCLUSIONS:Patients tend to prefer surgery for POP. When realistic assumptions for (dis)advantages are made, most women consider the disadvantages following both treatment options to be acceptable as they do not exceed the risks described in the literature.

journal_name

Gynecol Obstet Invest

authors

Thys SD,Roovers JP,Geomini PM,Bongers MY

doi

10.1159/000336634

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

6-12

issue

1

eissn

0378-7346

issn

1423-002X

pii

000336634

journal_volume

74

pub_type

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