背景与目的:盆腔器官脱垂(POP)是女性常见病,随着年龄的增长,并且可以显着影响许多人的生活质量(QOL)。这项研究的目的是评估总体改善情况,生活质量,在现实世界中,在24个月内继续进行POP的主要治疗。材料与方法:这是一个前瞻性的,观察,对有症状的POP妇女的随访研究,作为主要治疗方法,选择的建议(生活方式的改变和盆底肌肉训练),子宫托治疗,或手术。主要结果指标是24个月随访时的主观改善,用患者总体改善印象(PGI-I)量表测量。次要结局指标是主要治疗方法的延续率,停药的理由,用P-QoL问卷评价生活质量。结果:我们包括137名女性,推荐组中有45名女性(32.8%),阴道栓组39人(28.5%),手术组53名妇女(38.7%)。24个月后,手术,与子宫托治疗和建议相比,导致更多的女性报告主观改善:89.6%,66.7%,和22.9%(p<0.001),分别。总的来说,来自推荐组的52%的女性和来自阴道栓组的36.4%的女性在24个月内改用另一种治疗或停止主要治疗。然而,继续接受初级治疗的妇女,子宫托使用,和手术显示出类似的主观改善(90.5%和89.6%,分别)和生活质量的提高。结论:手术后明显改善的机会更高。然而,24个月后,阴道子宫托和手术均显示出重要的生活质量改善,可作为盆腔器官脱垂的主要治疗方法。
Background and Objectives: Pelvic organ prolapse (POP) is a common condition in women, with its prevalence increasing with age, and can significantly impact the quality of life (QOL) of many individuals. The objective of this
study was to assess the overall improvement, quality of life, and continuation of primary treatment for POP over a 24-month period in a real-world setting. Materials and Methods: This is a prospective, observational, follow-up
study of women with symptomatic POP who, as a primary treatment, opted for
recommendations (lifestyle changes and pelvic floor muscle training), pessary therapy, or surgery. The primary outcome measure was a subjective improvement at the 24-month follow-up, measured with the Patient Global Impression of Improvement (PGI-I) scale. Secondary outcome measures were the continuation rate of the primary treatment method, reason for discontinuation, and the quality of life evaluated with the P-QoL questionnaire. Results: We included 137 women, with 45 women (32.8%) in the
recommendations group, 39 (28.5%) in the pessary group, and 53 women (38.7%) in the surgery group. After 24 months, surgery, in comparison with pessary treatment and recommendations, resulted in significantly more women reporting a subjective improvement: 89.6%, 66.7%, and 22.9% (p < 0.001), respectively. Overall, 52% of women from the
recommendations group and 36.4% from the pessary group switched to another treatment or discontinued the primary treatment within 24 months. However, women who continued the primary treatment, pessary use, and surgery showed similar subjective improvements (90.5% and 89.6%, respectively) and quality-of-life improvement. Conclusions: The chance of significant improvement was higher following surgery. However, after 24 months, both vaginal pessaries and surgery showed an important quality-of life improvement and can be proposed as primary treatment methods for pelvic organ prolapse.