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

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.