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.

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.