Introduction The primary objective of this study was to investigate the percentages of women choosing watchful waiting, pessary use or surgery as first-line treatment of pelvic organ prolapse (POP). Second, the rate and cause of discontinuation of pessary use were investigated. Methods A retrospective chart review was conducted on 794 patients referred with POP at a Danish tertiary center for urogynecology at Aalborg University Hospital between 1 January 2014 and 31 December 2015. The following data were registered: age, BMI, previous use of a pessary, total number of births, vaginal births, cesarean sections, previous hysterectomy, prolapse surgery and incontinence surgery, smoking, menopause, sexual status and POP-Q stage in the three vaginal compartments. Pessary treatments were evaluated after 3 months. Additional visits, reason for discontinuation and secondary treatment were noted. Results First-line treatment was surgery in 50%, watchful waiting in 33% and pessary use in 17% of patients. Characteristics associated with choosing surgery instead of a pessary were age < 65 years, previous prolapse surgery, prolapse in the anterior or posterior compartment, and POP-Q stage > 2. Characteristics associated with choosing watchful waiting instead of a pessary were age < 65 years and prolapse in the posterior compartment. A total of 33% discontinued pessary treatment within the first 3 months. Discontinuation was associated with age < 65 years, previous hysterectomy and pelvic surgery, and additional visits. Expulsion of the pessary and pain/discomfort were the main causes of discontinuation. Conclusion This study showed that 50% of patients referred with POP were treated with conservative treatment (watchful waiting and pessary) and thus more women could probably be treated in primary care.

中文翻译：

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盆腔器官脱垂的一线治疗和停止子宫托治疗

介绍 本研究的主要目的是调查选择观察等待、使用子宫托或手术作为盆腔器官脱垂 (POP) 一线治疗的女性百分比。其次，调查了停止使用子宫托的比率和原因。方法 对 2014 年 1 月 1 日至 2015 年 12 月 31 日期间在丹麦奥尔堡大学医院泌尿妇科三级中心转诊的 794 名 POP 患者进行回顾性图表审查。分娩次数、阴道分娩、剖宫产、既往子宫切除术、脱垂手术和失禁手术、吸烟、更年期、性状态和三个阴道隔室中的 POP-Q 分期。3个月后评估子宫托治疗。额外的访问，记录停药和二次治疗的原因。结果 50%的患者一线治疗为手术，33%为观察等待，17%为使用子宫托。与选择手术而不是子宫托相关的特征是年龄 < 65 岁、之前进行过脱垂手术、前部或后部隔室脱垂以及 POP-Q 分期 > 2。与选择观察等待而不是子宫托相关的特征是年龄 < 65 岁和后室脱垂。共有 33% 的人在前 3 个月内停止了子宫托治疗。停药与年龄 < 65 岁、既往子宫切除术和盆腔手术以及额外就诊有关。子宫托脱落和疼痛/不适是停药的主要原因。