Outcomes at 12, 24, and 36 Months in Women Treated for Pelvic Organ Prolapse With Pessary or Surgery: Results From the Multicenter Pelvic Floor Disorders Registry.

IF 0.8 Q4 OBSTETRICS & GYNECOLOGY
Uduak U Andy, Leslie Meyn, Heidi W Brown, Pamela A Moalli, Cecile A Ferrando, Stuart Shippey, Ukpebo R Omosigho, Joseph T Kowalski, Noelani M Guaderrama, Jennifer T Anger, Raymond T Foster, Robert E Gutman, Ladin Yurteri-Kaplan
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Abstract

Objective: The aim of this study was to describe real-world outcomes in women treated for pelvic organ prolapse (POP) with pessary or surgery over 36 months.

Study design: We report outcomes of patients in a multicenter, prospective registry who opted for treatment of POP with either pessary (discontinuation or retreatment with surgery rates and subjective improvement) or surgery (retreatment rates or subjective improvement).

Results: Among 1,153 patients, follow-up was available for 248 (84%), 123 (42%), and 98 (33%) in the pessary group and 717 (93%), 407 (53%), and 331 (43%) in the surgery group at 12, 24, and 36 months, respectively. In the pessary group, rates of discontinuation and retreatment decreased over time with 82/248 patients (33%) discontinuing pessary use at 12 months, of whom 32 (39%) had surgery, 17/123 (14%) discontinuing at 24 months, of whom 7 had surgery, and 5/98 (5%) discontinuing at 36 months, of whom 2 had surgery. Subjective recurrence rates were 76/147 (52%), 4/99 (4%), and 11/87 (13%) at 12, 24, and 36 months, respectively. In the surgery group, the rate of retreatment was 15/717 (2%), 6/407 (1%), and 5/331 (2%) and the rate of subjective recurrence was 71/717 (10%), 8/407 (2%), and 13/331 (4%) at 12, 24, and 36 months.

Conclusions: In this real-world registry, we observed that approximately one third of patients discontinued pessary use during the first 12 months, which decreased over time. There were low rates of reintervention following surgical management over the 36-month period. Our data provide valuable information that may be helpful for clinicians in counseling patients about management of their POP.

接受盆腔器官脱垂或手术治疗的女性在12、24和36个月的结果:来自多中心盆底疾病登记处的结果。
目的:本研究的目的是描述盆腔器官脱垂(POP)的妇女接受子宫托或手术治疗超过36个月的真实结果。研究设计:我们报告了多中心前瞻性登记患者的结果,这些患者选择使用子宫托(手术率和主观改善的停药或再治疗)或手术(再治疗率或主观改善)进行POP治疗。结果:1153例患者中,子宫托组随访248例(84%)、123例(42%)、98例(33%),手术组随访717例(93%)、407例(53%)、331例(43%),随访时间分别为12个月、24个月、36个月。在子宫托组中,停药和再治疗的比率随着时间的推移而下降,有82/248例患者(33%)在12个月时停止使用子宫托,其中32例(39%)进行了手术,17/123例(14%)在24个月时停止使用,其中7例进行了手术,5/98例(5%)在36个月时停止使用,其中2例进行了手术。12、24、36个月主观复发率分别为76/147(52%)、4/99(4%)、11/87(13%)。手术组12、24、36个月的复发率分别为71/717(10%)、8/407(2%)、13/331(4%),复发率分别为15/717(2%)、6/407(1%)、5/331(2%)。结论:在这个真实世界的注册表中,我们观察到大约三分之一的患者在前12个月内停止了必要的子宫托使用,随着时间的推移减少。手术治疗后36个月的再干预率很低。我们的数据提供了有价值的信息,可能有助于临床医生在咨询患者管理他们的POP。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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