Skip to main content

Advertisement

Log in

One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Vaginal pessaries, pelvic floor exercises and surgery are treatment options for women with symptomatic pelvic organ prolapse (POP). The aim of this study was to compare the outcomes of pessaries and surgery in women with symptomatic POP using the validated International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) and Urinary Incontinence (ICIQ-UI) Short Form (SF).

Methods

Women attending the Urogynecology clinics with symptomatic POP were recruited. All women were treated using either a vaginal pessary or surgery. Outcomes were evaluated and then compared at 1 year using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires.

Results

A total of 287 women with symptomatic prolapse were recruited. 269 women completed the questionnaires at baseline and 183 at 1 year. At 1 year, improvement was noted in quality of life (QOL), frequency of urinary leak and vaginal symptoms in both groups except for the symptom of vaginal soreness in the pessary group and the symptom of a tight vagina in the surgery group. However, both these symptoms were not bothersome. Women who underwent surgery demonstrated an improvement in faecal evacuation and sex life. There was an overall statistically significant improvement in vaginal, sex, QOL and urinary symptom scores in both groups. No statistically significant difference was noted between the surgery and the pessary groups.

Conclusions

Using validated questionnaires 1 year after treatment, women with symptomatic POP report improvement in vaginal, bowel, urinary and quality of life scores when treated with either pessary use or surgery. No statistically significant difference was noted in the two groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hagen S, Stark D, Maher C, Adams E (2005) Conservative management of pelvic organ prolapse in women. Cochrane Database Syst Rev 4:CD003882

  2. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  CAS  PubMed  Google Scholar 

  3. Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V (2005) The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG 112:971–976

    Article  PubMed  Google Scholar 

  4. Braekken IH, Majida M, Engh ME, Bo K (2010) Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol 203(2):170.e1–170.e7

    Article  Google Scholar 

  5. Wilson PD, Berghmans B, Hagen S, Hay-Smith J, Moore K, Nygaard I et al (2005) Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 3rd edn. Health Publications, Plymouth, pp 936–943

    Google Scholar 

  6. Powers K, Lazarou G, Wang A, La Combe J, Besinger G, Greston WM et al (2006) Pessary use in advanced pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17:160–164

    Article  PubMed  Google Scholar 

  7. Thakar R, Stanton S (2002) Management of genital prolapse. BMJ 324(7348):1258–1262

    Article  PubMed Central  PubMed  Google Scholar 

  8. Jelovsek JE, Maher C, Barber MD (2007) Pelvic organ prolapse. Lancet 369(9566):1027–1038

    Article  PubMed  Google Scholar 

  9. Bash KL (2000) Review of vaginal pessaries. Obstet Gynecol Surv 55:455–460

    Article  CAS  PubMed  Google Scholar 

  10. Kapoor DS, Thakar R, Sultan AH, Oliver R (2009) Conservative versus surgical management of prolapse: what dictates patient choice? Int Urogynecol J Pelvic Floor Dysfunct 20(10):1157–1161

    Article  PubMed  Google Scholar 

  11. Kuhn A, Bapst D, Stadlmayr W, Vits K, Mueller MD (2009) Sexual and organ function in patients with symptomatic prolapse: are pessaries helpful? Fertil Steril 91(5):1914–1918

    Article  PubMed  Google Scholar 

  12. Fernando RJ, Thakar R, Sultan AH, Shah SM, Jones PW (2006) Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse. Obstet Gynaecol 108(1):93–99

    Article  Google Scholar 

  13. Komesu YM, Rogers RG, Rode MA, Craig EC, Gallegos KA, Montoya AR et al (2007) Pelvic floor symptom changes in pessary users. Am J Obstet Gynecol 197:620e1–620e6

    Article  Google Scholar 

  14. Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL (2004) Patient satisfaction and changes in prolapse and urinary symptoms in women who are fitted successfully with a pessary for pelvic organ prolapse. Am J Obstet Gynecol 190(4):1025–1029

    Article  PubMed  Google Scholar 

  15. Abdool Z, Thakar R, Sultan AH, Oliver R (2011) Prospective evaluation of outcome of vaginal pessaries versus surgery in women with symptomatic pelvic organ prolapse. Int Urogynecol J 22:273–278

    Article  PubMed  Google Scholar 

  16. Bradshaw HD, Hiller L, Farkas AG, Radley S, Radley SC (2006) Development and psychometric testing of a symptom index for pelvic organ prolapse. J Obstet Gynaecol 26:241–252

    Article  CAS  PubMed  Google Scholar 

  17. Price N, Jackson SR, Avery K, Brookes ST, Abrams P (2006) Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ-VS. BJOG 113(6):700–712

    Article  CAS  PubMed  Google Scholar 

  18. Avery K, Donovan J, Peters T, Shaw C, Gotoh M, Abrams P (2004) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 23(4):322–330

    Article  PubMed  Google Scholar 

  19. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ Prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17

    Article  CAS  PubMed  Google Scholar 

  20. Adams EJ, Thomson AJM, Maher C, Hagen S (2004) Mechanical devices for pelvic organ prolapse in women. Cochrane Database Syst Rev 2:CD004010

    PubMed  Google Scholar 

  21. Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 3:CD004014. doi:10.1002/14651858.CD004014

    PubMed  Google Scholar 

  22. Lone F, Thakar R, Sultan AH, Karamalis G (2011) A 5-year prospective study of vaginal pessary use for pelvic organ prolapse. Int J Gynecol Obstet 114:56–59

    Article  Google Scholar 

  23. Barber MD, Walters MD, Cundiff GW, PESSRI Trial Group (2006) Responsiveness of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) in women undergoing vaginal surgery and pessary treatment for pelvic organ prolapse. Am J Obstet Gynecol 194(5):1492–1498

    Article  PubMed  Google Scholar 

  24. Hullfish KL, Bovbjerg VE, Gurka MJ, Steers WD (2008) Surgical versus nonsurgical treatment of women with pelvic floor dysfunction: patient centered goals at 1 year. J Urol 179:2280–2285

    Article  PubMed Central  PubMed  Google Scholar 

  25. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) King’s Health Questionnaire (KHQ). A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379

    Article  CAS  PubMed  Google Scholar 

  26. Schaffer J, Cundiff GW, Amundsen CL, Bent A, Coates KW, Strohbehn K et al (2006) Do pessaries improve lower urinary tract symptoms? J Pelvic Med Surg 12:72–73

    Article  Google Scholar 

  27. Moore KN, Dumoulin C, Bradley C, Burgio K, Chambers T, Hagen S, Hunter KF, Imamura M, Thakar R, Williams K (2013) Adult conservative management. In: Abrams PH, Cardozo L, Khoury AE, Wein A (eds) Fifth International Consultation on Incontinence, 5th edn. Health Publications, Plymbridge, pp 1101–1227

    Google Scholar 

  28. Lambrou NC, Buller JL, Thompson JR, Cundiff GW, Chou B, Montz FJ (2000) Prevalence of perioperative complications among women undergoing reconstructive pelvic surgery. Am J Obstet Gynecol 183:1355–1358

    Article  CAS  PubMed  Google Scholar 

Download references

Financial disclaimer/conflict of interest

Farah Lone: none; Ranee Thakar: Secretary IUGA, Honorarium and Astellas speaker; Abdul H. Sultan: Pfizer and Astellas speaker.

Authors’ contributions

F. Lone: project development, data collection, data analysis, manuscript writing; R. Thakar: project development, manuscript editing; A.H. Sultan: project development, manuscript editing.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ranee Thakar.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lone, F., Thakar, R. & Sultan, A.H. One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires. Int Urogynecol J 26, 1305–1312 (2015). https://doi.org/10.1007/s00192-015-2686-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-015-2686-9

Keywords

Navigation