Obliterative Procedures for Pelvic Organ Prolapse

Evans, J.P.; Karram, Mickey M.

doi:10.1016/b978-1-4160-6266-0.00010-1

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…It has been estimated that, by 2050, 33% of women in the United States will have postmenopausal status. 15 Ringa et al 16 analyzed various components of sexuality and reported that women did not differ in sexual activity according to hormonal status. The results suggested that the hormonal and biological changes that characterize menopause do not negatively affect sexual activity.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of UI type was based on clinical complaints, according to the standardization developed by the ICS. The condition was then classified according to the International Consultation on Incontinence Questionnaire -Short Form (ICIQ-SF) total score, as slight (1-5), moderate (6)(7)(8)(9)(10)(11)(12), severe (13)(14)(15)(16)(17)(18) or very severe (19)(20)(21). 11,12 Perineal sensitivity and anal reflex were tested to investigate the integrity of the motor component of the pudendal nerve: bulbocavernosus cough and anocutaneous reflexes.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Sexual Activity for Women with Pelvic Floor Dysfunction - A Cross-Sectional Study

Macêdo

Neto

Tamanini

et al. 2020

Rev Bras Ginecol Obstet

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Objective To examine women with pelvic floor dysfunction (PFDs) and identify factors associated with sexual activity (SA) status that impacts quality of life (QoL). Methods We conducted a cross-sectional study that included women > 18 years old who presented with at least one PFD symptom (urinary incontinence [UI] and/or pelvic organ prolapse [POP]), in outpatient clinics specializing in urogynecology and PFD in Fortaleza, state of Ceará, Brazil, using a service evaluation form and QoL questionnaires. Results The analysis of 659 women with PFD included 286 SA (43.4%) women and 373 non-sexually active (NSA) (56.6%) women, with a mean age of 54.7 (±12) years old. The results revealed that age (odds ratio [OR] = 1.07, 95% confidence interval [CI] 1.03–1.12) and post-menopausal status (OR = 2.28, 95% CI 1.08–4.8) were negatively associated with SA. Being married (OR = 0.43, 95% CI 0.21–0.88) was associated with SA. Pelvic organ prolapse (OR = 1.16, 95% CI 0.81–1.68) and UI (OR = 0.17, 95% CI 0.08–0.36) did not prevent SA. SF-36 Health Survey results indicated that only the domain functional capacity was significantly worse in NSA women (p = 0.012). Two King's Health Questionnaire domains in NSA women, impact of UI (p = 0.005) and personal relationships (p < 0.001), were significantly associated factors. Data from the Prolapse Quality-of-life Questionnaire indicated that NSA women exhibited compromised QoL. Conclusion Postmenopausal status and age negatively affected SA. Being married facilitated SA. Presence of POP and UI did not affect SA. However, NSA women with POP exhibited compromised QoL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors Associated with Sexual Activity for Women with Pelvic Floor Dysfunction - A Cross-Sectional Study

Macêdo

Neto

Tamanini

et al. 2020

Rev Bras Ginecol Obstet

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“…Pelvic organ prolapse (POP) is a gynaecological condition in which one or more of the pelvic organs (ie, uterus, rectum, bladder, small bowel) herniate into the vagina due to weakness or damaging of the pelvic floor muscles and ligaments 1 2. POP symptoms (eg, urinary, bowel and sexual dysfunction) are associated with decreased quality of life 3.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of pessary therapy versus surgery for symptomatic pelvic organ prolapse: an economic evaluation alongside a randomised non-inferiority controlled trial

Ben,

van der Vaart,

E. Bosmans

et al. 2024

BMJ Open

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ObjectiveTo evaluate the cost-effectiveness of pessary therapy as an initial treatment option compared with surgery for moderate to severe pelvic organ prolapse (POP) symptoms in secondary care from a healthcare and a societal perspective.DesignEconomic evaluation alongside a multicentre randomised controlled non-inferiority trial with a 24-month follow-up.Setting21 hospitals in the Netherlands, recruitment conducted between 2015 and 2022.Participants1605 women referred to secondary care with symptomatic prolapse stage ≥2 were requested to participate. Of them, 440 women gave informed consent and were randomised to pessary therapy (n=218) or to surgery (n=222) in a 1:1 ratio stratified by hospital.InterventionsPessary therapy and surgery.Primary and secondary outcome measuresThe Patient Global Impression of Improvement (PGI-I), a 7-point scale dichotomised into successful versus unsuccessful, with a non-inferiority margin of −10%; quality-adjusted life-years (QALYs) measured by the EQ-5D-3L; healthcare and societal costs were based on medical records and the institute for Medical Technology Assessment questionnaires.ResultsFor the PGI-I, the mean difference between pessary therapy and surgery was −0.05 (95% CI −0.14; 0.03) and −0.03 (95% CI −0.07; 0.002) for QALYs. In total, 54.1% women randomised to pessary therapy crossed over to surgery, and 3.6% underwent recurrent surgery. Healthcare and societal costs were significantly lower in the pessary therapy (mean difference=−€1807, 95% CI −€2172; −€1446 and mean difference=−€1850, 95% CI −€2349; −€1341, respectively). The probability that pessary therapy is cost-effective compared with surgery was 1 at willingness-to-pay thresholds between €0 and €20 000/QALY gained from both perspectives.ConclusionsNon-inferiority of pessary therapy regarding the PGI-I could not be shown and no statistically significant differences in QALYs between interventions were found. Due to significantly lower costs, pessary therapy is likely to be cost-effective compared with surgery as an initial treatment option for women with symptomatic POP treated in secondary care.Trial registration numberNTR4883.

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Colpocleisis for Advanced Pelvic Organ Prolapse

Samimi

Zimmerman

2020

Curr Bladder Dysfunct Rep

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Obliterative Procedures for Pelvic Organ Prolapse

Cited by 4 publications

References 15 publications

Factors Associated with Sexual Activity for Women with Pelvic Floor Dysfunction - A Cross-Sectional Study

Factors Associated with Sexual Activity for Women with Pelvic Floor Dysfunction - A Cross-Sectional Study

Cost-effectiveness of pessary therapy versus surgery for symptomatic pelvic organ prolapse: an economic evaluation alongside a randomised non-inferiority controlled trial

Colpocleisis for Advanced Pelvic Organ Prolapse

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