Pelvic Organ Prolapse*

Harrison, Benjamin P.; Cespedes, R. Duane

doi:10.1016/s0733-8627(05)70215-7

Cited by 16 publications

(2 citation statements)

References 21 publications

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“…The possible justification is because coughing repeatedly and/or forcefully can stretch pelvic floor tissues, weaken the pelvic floor, which in turn forces the pelvic floor to move downward, worsen prolapse symptoms, and increase the degree of prolapse. 41 , 42 …”

Section: Discussionmentioning

confidence: 99%

Pelvic organ prolapse and associated factors among women admitted to gynecology ward at the Hiwot Fana Comprehensive Specialized Hospital, Harar, eastern Ethiopia

et al. 2022

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Objectives: The major aim of this study was to assess the magnitude of pelvic organ prolapse and its associated factors among patients admitted to the gynecology ward at Hiwot Fana Specialized University Hospital, eastern Ethiopia. Methods: A retrospective review of records was undertaken at Hiwot Fana Specialized University Hospital. We used a simple random sampling technique to pick 387 gynecology ward–admitted patient records from 30 December 2020 to 10 January 2021. Data were extracted from maternal medical charts using a pretested checklist. The extracted data were entered into EpiData version 3.1 and then exported into SPSS version 25 for analysis. Binary logistic regression was carried out to observe a significant correlation between independent and pelvic organ prolapse. An adjusted odds ratio and 95% confidence interval was used to report the result. A p-value of less than 0.05 was used to declare statistical significance. Results: Among 387 responded women, 39 (10.1%; 95% confidence interval = 8.3–15.6) of them had at least one stage of pelvic organ prolapse. Multiparty (adjusted odds ratio = 1.88, 95% confidence interval = 1.41–10.60), grand multiparty (adjusted odds ratio = 2.63, 95% confidence interval = 1.53–12.90), older maternal age (adjusted odds ratio = 2.29, 95% confidence interval = 1.220–7.52), lifting a heavy object (adjusted odds ratio = 4.61, 95% confidence interval = 2.31–15.83), and having chronic cough (adjusted odds ratio = 2.39, 95% confidence interval = 1.10–5.19) were significantly associated with pelvic organ prolapse. Conclusion: Among women admitted to the hospital because of gynecological morbidity, one in ten of them had pelvic organ prolapse. Multiparty, advanced maternal age, having a chronic cough, and lifting heavy objects were identified to be risk factors for pelvic organ prolapse. Tailored primary prevention would enhance the well-being of reproductive-age women.

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Section: Discussionmentioning

confidence: 99%

Pelvic organ prolapse and associated factors among women admitted to gynecology ward at the Hiwot Fana Comprehensive Specialized Hospital, Harar, eastern Ethiopia

et al. 2022

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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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