Abstract
Nonsurgical management of pelvic organ prolapse is generally accepted as first-line therapy for symptomatic patients and includes expectant management, pelvic floor muscle training, or pessary use. The objective of this article is to review the available evidence comparing nonsurgical and surgical options for pelvic organ prolapse.
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References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–83.
Wu JM, Matthews CA, Conover MM, Pate V, Jonsson FM. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6.
ACOG Committee on Practice Bulletins - Gynecology. ACOG practice bulletin No, 85: pelvic organ prolapse. Obstet Gynecol. 2007;110(3):717–29.
Brækken IH, Majida M, Engh ME, Bø K. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol. 2010;203(2):170. e1–7.
Ghroubi S, Kharrat O, Chaari M, Ben Ayed B, Guermazi M, Elleuch MH. Effect of conservative treatment in the management of low-degree urogenital prolapse. Ann Readapt Med Phys. 2008;51:96–102.
Hagen S, Stark D, Glazener C, Sinclair L, Ramsay I. A randomised controlled trial of pelvic floor muscle training for stage I and II pelvic organ prolapse. Int Urogynecol J. 2009;20:45–51.
Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapsed in women. Cochrane Database Syst Rev. 2011;12. Important reference on this topic of prevention and management of pelvic organ prolapse.
Hagen S, Stark D, Glazener C, Dickson S, Barry S, Elders A, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383(9919):796–806.
Bugge C, Adams EJ, Gopinath D, Reid F. Pessaries (mechanical devices) for pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;2
Cundiff GW, Weidner AC, Visco AG, Bump RC, Addison WA. A survey of pessary use by members of the American Urogynecologic Society. Obstet Gynecol. 2000;95(6):931–5. Part 1.
Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL. Risk factors associated with an unsuccessful pessary fitting trial in women with pelvic organ prolapse. Am J Obstet Gynecol. 2004;190(2):345–50.
Geoffrion R, Zhang T, Lee T, Cudiff GW. Clinical characteristics associated with unsuccessful pessary fitting outcomes. Female Pelvic Med Reconstr Surg. 2013;19(6):339–45.
Cundiff GW, Amundsen CL, Bent AE, Coates KW, Schaffer JI, Strohbehn K, et al. The PESSRI study: symptom relief outcomes of a randomized crossover trial of the ring and Gellhorn pessaries. Am J Obstet Gynecol. 2007;196(4):405–e1.
Sarma S, Ying T, Moore KH. Long-term vaginal ring pessary use: discontinuation rates and adverse events. BJOG. 2009;116(13):1715–21.
Lone F, Thakar R, Sultan AH, Karamalis G. A 5-year prospective study of vaginal pessary use for pelvic organ prolapse. Int J Gynaecol Obstet. 2011;114(1):56–9.
Tenfelde S, Tell D, Thomas TN, Kenton K. Quality of life in women who use pessaries for longer than 12 months. Female Pelvic Med Reconstr Surg. 2015;21(3):146–9.
Wiegersma M, Panman CM, Kollen BJ, Vermeulen KM, Schram AJ, Messelink EJ, et al. Pelvic floor muscle training versus watchful waiting or pessary treatment for pelvic organ prolapse (POPPS): design and participant baseline characteristics of two parallel pragmatic randomized controlled trials in primary care. Maturitas. 2014;77(2):168–73.
Abdool Z, Thakar R, Sultan AH, Oliver RS. Prospective evaluation of outcome of vaginal pessaries versus surgery in women with symptomatic pelvic organ prolapse. Int Urogynecol J. 2011;22(3):273–8.
Lone F, Thakar R, Sultan AH. One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires. Int Urogynecol J. 2015;26(9):1305–12.
Jarvis SK, Hallam TK, Lujic S, Abbott JA, Vancaillie TG. Peri-operative physiotherapy improves outcomes for women undergoing incontinence and or prolapse surgery: results of a randomised controlled trial. Aust N Z J Obstet Gynaecol. 2005;45:300–3.
Frawley HC, Phillips BA, Bø K, Galea MP. Physiotherapy as an adjunct to prolapse surgery: an assessor-blinded randomized controlled trial. Neurourol Urodyn. 2010;29:719–25.
Barber MD, Brubaker L, Burgio KL, Richter HE, Nygaard I, Weidner AC, et al. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. JAMA. 2014;311(10):1023–34.
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Nathan Kow, Lauren Siff, and Tanaz R. Ferzandi declare that they have no conflict of interest.
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This article is part of the Topical Collection on Pelvic Organ Prolapse
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Kow, N., Siff, L. & Ferzandi, T.R. Nonsurgical vs. Surgical Treatment Options for Pelvic Organ Prolapse: Review of the Current Evidence. Curr Obstet Gynecol Rep 5, 172–175 (2016). https://doi.org/10.1007/s13669-016-0157-z
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DOI: https://doi.org/10.1007/s13669-016-0157-z