1. Comparison of outcomes between pessary use and surgery for symptomatic pelvic organ prolapse: A prospective self-controlled study
- Author
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Brian J. Linder, John B. Gebhart, Amy L. Weaver, Felecia R. Fick, Randina R. Harvey-Springer, Emanuel C. Trabuco, Christopher J. Klingele, and John A. Occhino
- Subjects
pelvic floor ,urinary bladder ,overactive ,urinary incontinence ,urologic surgical procedures ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Purpose: We compared the degree of pelvic floor symptom improvement between pessary use and prolapse surgery. Materials and Methods: Pessary-naïve women who elected prolapse surgery were enrolled and used a pessary preoperatively (for ≥7 days and ≤30 days). Pelvic floor symptoms were assessed at baseline, after pessary use, and at 3 months postoperatively. The primary outcome was concordance in the degree of symptoms improvement between pessary use and surgery, as assessed by Patient Global Impression of Improvement (PGI-I). Secondary outcomes were related to prolapse specific symptoms on validated questionnaires (POPDI-6, PFIQ-7). The McNemar test was used for comparisons of discordant pairs for comparisons of the PGI-I ratings after pessary use and surgery. Results: Sixty-one participants were enrolled (March 2016 through April 2019) and 58 patients used a pessary. Mean±standard deviation age was 60.7±10.7 years; 24.1% had prior hysterectomy, and 13.8% had prior prolapse surgery. While both treatments demonstrated symptomatic improvement, concordance in the degree of overall improvement on the PGI-I score was poor (n=40); responses significantly favored more improvement postoperatively (p
- Published
- 2022
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