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首页> 外文期刊>Archives of gynecology and obstetrics. >Prolapse surgery versus vaginal pessary in women with symptomatic pelvic organ prolapse: which factors influence the choice of treatment?
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Prolapse surgery versus vaginal pessary in women with symptomatic pelvic organ prolapse: which factors influence the choice of treatment?

机译：脱垂手术与患有症状骨盆器官脱垂的女性中的阴道宫颈：哪些因素影响治疗的选择？

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ObjectiveTo investigate which specific clinical factors influence patients' choice of prolapse treatment.MethodsThis study includes a total of 510 cases with symptomatic pelvic organ prolapse (POP) of stage II or higher requiring prolapse treatment. Patients were divided into surgery and pessary groups according to their own choice and treatment preference. Primary outcome of interest was to define potential clinical parameters, which contribute to surgical treatment decision.ResultsA total of 252/510 (49%) women decided for prolapse surgery and 258/510 (51%) cases were treated conservatively with vaginal pessary. Hypertension, COPD as well as polypharmacy were parameters, which were statistically significantly more common in the pessary group compared to the surgically managed cases (p0.05). On the contrary, women undergoing prolapse surgery were significantly younger and showed more advanced POP-Q (pelvic organ prolapse quantification) stages (p0.05). Clinical factors, such as BMI (body mass index), parity, mode of delivery and postmenopausal status, did not differ between the two groups (p0.05). Multiple logistic regression analysis revealed that advanced POP-Q stage (p0.001) as well as the absence of smoking (p0.001) were independent factors associated with surgical treatment decision.ConclusionWomen, who favoured prolapse surgery, were younger and in significant better health condition (less hypertension and COPD), but showed a significantly higher POP-Q stage compared to women choosing pessary treatment. Our data indicate that women with higher POP-Q stage and non-smokers tended to decide for prolapse surgery. This information could help in clinical practice to guide patients for the best possible treatment decision and strengthen individual counselling.
机译：ObjectiveTo调查哪些特定的临床因素影响患者的脱垂治疗方法。方法包括总共510例患有症状骨盆器官脱垂（POP）的阶段II或更高的需要脱垂治疗。根据自己的选择和治疗偏好，患者分为手术和比例组。兴趣的主要结果是定义潜在的临床参数，这些参数有助于外科治疗决策。患者共252/510（49％）妇女决定脱垂手术，阴道宫颈癌保守治疗258/510（51％）病例。高血压，COPD以及PolyPharcacy是参数，与手术疾病的病例相比，宫内组在统计学上有统计学上显着更常见（P <0.05）。相反，正在进行脱垂手术的女性显着下降，并且显示出更先进的POP-Q（盆腔器官脱垂量化）阶段（P <0.05）。临床因素，如BMI（体重指数），奇偶校验，递送模式和绝经后状态，两组之间没有区别（P＆GT; 0.05）。多元逻辑回归分析显示，晚期POP-Q阶段（P <0.001）以及没有吸烟（P <0.001）是与手术治疗决策相关的独立因素。合并脱垂手术的组织，较年轻，更好健康状况（少高血压和COPD），但与选择PESSARY治疗相比，展示了一个明显更高的POP-Q阶段。我们的数据表明，具有较高流行型阶段和非吸烟者的妇女倾向于决定脱垂手术。这些信息有助于临床实践，以指导患者获得最佳的治疗决策，并加强个别咨询。

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