Cited by 61Pelvic floor disorders treatmentsSexual function and dysfunction studiesUterine Myomas and Treatments

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Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse: 2-year follow-up of a randomized controlled trial in primary care

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Panman, Chantal M.C.R., Wiegersma, Marian, Kollen, Boudewijn J., Berger, Marjolein Y., Lisman-van Leeuwen, Yvonne, Vermeulen, Karin M., Dekker, Janny H.·2016·Menopause

DOI 10.1097/gme.0000000000000706

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Abstract

Objective: We investigated the effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training (PFMT) in women with pelvic organ prolapse over a 2-year period. Methods: Randomized controlled trial with women (≥55 y) with symptomatic pelvic organ prolapse, identified by screening. Participants were recruited from 20 primary care practices (October 2009-December 2012). Primary outcome was the difference in change of pelvic floor symptoms (PFDI-20 score) between groups over 24 months. Secondary outcomes included prolapse, urinary, and anorectal symptoms; quality of life; costs; sexual functioning; prolapse stage; pelvic floor muscle function; and participants’ perceived symptom improvement. Results: There was a nonsignificant difference in the primary outcome between pessary treatment (n = 82) and PFMT (n = 80) with a mean difference of −3.7 points (95% CI, −12.8 to 5.3; P = 0.42) in favor of pessary treatment. A significantly greater improvement in the prolapse symptom score was, however, seen with pessary treatment (mean difference −3.2 points [95% CI, −6.3 to −0.0; P = 0.05]). Direct medical costs over the 2-year study were $309 and $437 per person for pessary treatment and PFMT, respectively. Conclusions: In older women with symptomatic prolapse, there was no significant difference between pessary treatment and PFMT in reducing pelvic floor symptoms, but specific prolapse-related symptoms did improve more with pessary treatment. Pessary treatment was preferable in the cost-effectiveness analysis. When counseling women for prolapse treatment it should, however, be taken into account that pessary fitting fails in a considerable portion of women and that pessary treatment was associated with more side effects compared with PFMT.

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Authors: Panman, C. M. C. R., Wiegersma, M., Kollen, B. J., Berger, M. Y., Lisman-van Leeuwen, Y., Vermeulen, K. M., & Dekker, J. H.
Affiliations: Department of General Practice
University Medical Center Groningen (NL)
Corresponding author: Dekker, Janny H.
ORCID: Kollen, Boudewijn J.
Berger, Marjolein Y.
Vermeulen, Karin M.
Dekker, Janny H.
Venue: Menopause
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2016-12
Volume: 23
Issue: 12
Pages: 1307-1318
ISSN: 1072-3714 (ISSN-L)
1530-0374
DOI: 10.1097/gme.0000000000000706
OpenAlex: W2513095721
Cited by: 61
References: 49
Citations by year: 2026: 3 · 2025: 7 · 2024: 7 · 2023: 5 · 2022: 8 · 2021: 11 · 2020: 11 · 2019: 2 · 2018: 4 · 2017: 3
FWCI: 3.19
Type: journal article
Language: en
Open access: green
research.rug.nl
Licence: other-oa
Locations: Menopause The Journal of The North American Menopause Society (publishedVersion)
PubMed (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Funders: ZonMw (4201.1001)
Topics: Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
Keywords: pelvic organ prolapse, pessary, pelvic floor muscle training, older women, cost-effectiveness, pelvic floor symptoms, PFDI-20, urinary symptoms, anorectal symptoms, quality of life, sexual function, primary care
MeSH terms: Aged, Cost-Benefit Analysis, Exercise Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Pessaries, Primary Health Care, Treatment Outcome, Pelvic Floor, Pelvic Organ Prolapse

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Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse: 2-year follow-up of a randomized controlled trial in primary care

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