Different treatment tactics of the pelvic organ prolapse according to the type and the degree of the prolapse: A narrative review

Abstract

Background: Women frequently experience pelvic organ prolapse, significantly impacting their quality of life. Pelvic organ prolapse has a variety of treatment opportunities that should be used to each patient's needs, but the general rule is that only those exhibiting symptoms should receive care. Aim: to evaluate the treatment options for prolapse, depending on the type of prolapse and its degree. Methods: In this review, English studies from common databases such as Pubmed/MEDLINE, Web of science, Scopus, and the Cochrane Library with the keywords “pelvic organ prolapse,” “uterine prolapse,” “vaginal hysterectomy,” combined with keywords, involving “laparoscopic hysterectomy,” were involved. The end date for this review is February 2022. Scientific novelty: The main objective of this paper is to evaluate the treatment options for prolapse, depending on the type of prolapse and its degree. Even though many researchers assessed these treatment options, very few researchers reported about the treatment options according to the degree of prolapse. Many researchers compared surgical interventions for the management of pelvic organ prolapse. Though there are similar works, in the present study, the results of the surgical management depending on the severity of the prolapse were evaluated. The practical significance of the result obtained: The results may help physicians to determine the option of management depending on the degree of prolapse. First-degree (mild) usually does not require any treatment. Second-degree (moderate) may be treated with pessary, exercise, and surgery. Third-degree (severe) may be treated with pessary or surgery. Fourth-degree (complete) may be treated with vaginal hysterectomy, sacrocolpopexy, colpocleisis, and uterosacral ligament suspension. Conclusion: Depending on the surgeon's expertise, using various approaches, pelvic organ prolapse treatment is accomplished in various situations. All previous research indicate that surgery aims to maximise patient satisfaction and return the pelvic organs to their original positions.