Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Nov;310(5):2737-2744.
doi: 10.1007/s00404-024-07723-8. Epub 2024 Sep 6.

The influence of decisional conflict on treatment decision in pelvic organ prolapse-data from the SHADE-POP trial

Larissa E Drost  1   2 , Rachel D M de Jong  3 , Marjan Stegeman  3 , Arie Franx  4 , M Caroline Vos  3
Affiliations
Randomized Controlled Trial

The influence of decisional conflict on treatment decision in pelvic organ prolapse-data from the SHADE-POP trial

Larissa E Drost et al. Arch Gynecol Obstet. 2024 Nov.

Abstract

Purpose: Women with symptomatic pelvic organ prolapse are facing the choice between several treatment options and a potentially difficult decision. The aim of this study was to examine the effect of decisional conflict, patient characteristics and other decision-related factors on treatment decision in women with pelvic organ prolapse.

Methods: Data from the SHADE-POP trial were used. Women with symptomatic pelvic organ prolapse who visited their gynaecologist for (new) treatment options were included. In all participants, demographical characteristics and validated questionnaires concerning decisional conflict (DCS), shared decision making (SDM-Q-9), information provision (SCIP-B), anxiety and depression (HADS) and satisfaction with care (PSQ-18) were collected 2 weeks after the visit. Analyses were performed using univariate and multivariate linear and logistic regression analyses.

Results: Ninety six women with pelvic organ prolapse facing a treatment decision were included. An increase in decisional conflict as experienced by patients was related to the choice of more conservative treatment, such as pelvic floor muscle training or pessary, instead of surgery (p = 0.02). Shared decision making, better information provision and satisfaction with care were related to lower levels of decisional conflict (p = 0.001).

Conclusion: Decisional conflict in women with pelvic organ prolapse favours conservative treatment instead of surgery. Gaining knowledge on the effect of decisional conflict, patient characteristics and other decision-related factors on treatment decision in pelvic organ prolapse will be a step towards a better-guided treatment decision and better patient-reported outcomes for this group of patients. NL 55737.028.15, 30-10-2016.

Keywords: Decisional support; Patient participation; Pelvic organ prolapse; Shared decision making; Urogynaecology.

PubMed Disclaimer

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose. This study was performed in line with the principles of the Declaration of Helsinki.

Figures

Fig. 1
Fig. 1
Flowchart enrolment numbers
See this image and copyright information in PMC

References

    1. de Albuquerque Coelho SC, de Castro EB, Juliato CR (2016) Female pelvic organ prolapse using pessaries: systematic review. Int Urogynecol J 27:1797–1803 - PubMed
    1. Li C, Gong Y, Wang B (2016) The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. Int Urogynecol J 27:981–992 - PubMed
    1. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J (2016) Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev 11:CD004014 - PMC - PubMed
    1. Jelovsek JE, Maher C, Barber MD (2007) Pelvic organ prolapse. Lancet 369:1027–1038 - PubMed
    1. Mattsson NK, Karjalainen PK, Tolppanen AM, Heikkinen AM, Sintonen H, Harkki P et al (2020) Pelvic organ prolapse surgery and quality of life-a nationwide cohort study. Am J Obstet Gynecol 222(588):e1–e10 - PubMed

Publication types

LinkOut - more resources