Abstract
IntroductionWe investigated the clinicopathologic features, method of treatment, and complications related to the conservative treatment and surgical treatment of patients with pelvic organ prolapse (POP).MethodsWe retrospectively analyzed 288 patients who were diagnosed with POP from January 2007 to December 2017. The patients were divided into two groups according to the treatment method (Group A received conservative treatment and Group B received surgical treatment). The patients' clinicopathologic characteristics, treatment method, and post-treatment complications were compared between groups A and B.ResultsOf the total 288 patients, 83 and 205 patients were assigned to Groups A and B, respectively. The most common symptom was a bearing-down sensation (n = 205, 71.2%), which was reported in 51 (61.4%) and 154 (75.1%) patients from Groups A and B, respectively. Among underlying diseases, hypertension was the most common in both groups (40 and 102 patients in Groups A and B, respectively). Overall, 205 patients underwent surgery, 23 underwent vaginal pessary, and 60 performed pelvic floor muscle exercises. The incidence of treatment-related complications was not significantly different between Groups A and B (13.3% vs. 17.6%, p = 0.37). Perioperative complications were noted in 20 (17.8%) patients and vault prolapse requiring subsequent surgery was noted in 16 (14.1%) patients.ConclusionAs surgical treatment is associated with recurrence and complications, conservative treatment methods can be initially considered for patients with POP. In this study, there was no difference in the incidence of complications between surgical and conservative treatments. Thus, if required, surgical treatment can be safely performed in patients with POP.
Highlights
Pelvic organ prolapse (POP) is the descent of one or more of the female pelvic organ into the vagina
The incidences of cystocele and rectocele were higher in Group B than in Group A
In stage 2 and 3 patients, surgical treatment was more frequent than conservative treatment
Summary
Pelvic organ prolapse (POP) is the descent of one or more of the female pelvic organ (vagina, uterus, bladder, rectum) into the vagina. Most patients with POP are asymptomatic and do not require treatment. Symptoms associated with POP vary and the feeling of vaginal bulging or pressure is the common and specific symptom [3,4]. Treatment should be individualized according to the severity of symptoms and patient preferences. Potential options for POP treatment include expectant management, conservative treatment, including vaginal pessaries or pelvic floor muscle exercises, and various methods of surgery [6]. POP is a common disease in elderly patients with comorbidities. Surgery has traditionally been associated with a recurrence or re-operation rate of up to 30% after the initial surgery conservative treatments are attempted first [7,8], but POP is a chronic problem that eventually requires surgery. Our present study investigated the clinicopathologic characteristics, method of treatment, and post-treatment complications of POP in South Gyeongsang Province of South Korea between 2007 and 2017, using hospital-based clinical data
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