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

Abstract

Introduction and hypothesis: The aim of this study is to evaluate and compare the effectiveness of pessaries and surgery in women with symptomatic pelvic organ prolapse.

Methods: A total of 554 women with symptomatic pelvic organ prolapse (POP) were recruited and treated with either a vaginal pessary (n = 359) or surgery (n = 195). Using the validated Sheffield POP questionnaire, outcomes were evaluated and then compared at 1 year.

Results: At 1 year, the only significant difference between the two groups was increased frequency of intercourse in the surgery group (54% vs 46%; p = 0.028), which was not significant when controlled for age. There was a statistically significant improvement in prolapse, urinary, bowel, and sexual function in both pessary users and those treated surgically.

Conclusions: One year after treatment, women with POP report similar improvement in urinary, bowel, sexual function, and quality of life parameters when treated with pessary or surgical correction.