Research evaluates treatment options for pelvic organ prolapse

January 12, 2017

Pelvic organ prolapse 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 treatment.

Research on this topic has been published in the American Journal of Obstetrics & Gynecology. The research was conducted by Vivian W. Sung, MD, FACOG; Kyle J. Wohlrab, MD, FACOG; 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, ScD, 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 greater improvements.

"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.
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Covering the full spectrum of the specialty, American Journal of Obstetrics & Gynecology presents the latest diagnostic procedures, leading-edge research, and expert commentary in maternal-fetal medicine, reproductive endocrinology and infertility, gynecologic oncology, and urogynecology, as well as general obstetrics and gynecology.

About Women & Infants Hospital

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the 12th largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country's largest, single-family room neonatal intensive care unit.

Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's first mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the Pelvic Floor Disorders Network.

Care New England

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