Medical articles

CONSERVATIVE METHODS FOR TREATING PELVIC ORGAN PROLAPSE. NEW EVIDENCE FOR EFFECTIVENESS

CONSERVATIVE METHODS FOR TREATING PELVIC ORGAN PROLAPSE. NEW EVIDENCE FOR EFFECTIVENESS

G.B. Dicke

For quotation:

Dicke G.B. Conservative methods of treating pelvic organ prolapse. New evidence

efficiency. Questions of practical colposcopy. Genital infections. 2023; (1): 46–52.

DOI 10.46393/27826392_2023_1_46

Annotation:

The goal is to determine the effectiveness of pelvic floor muscle training (PFMT) and gynecological pessaries in the treatment of patients with pelvic organ prolapse (POP), as well as to provide information about new tools for their implementation.

Material and methods. The results of 24 studies with a high level of evidence published in foreign databases PubMed, Google Scholar, Embase and the Cochrane Register of Systematic Reviews (CDSR) and Controlled Trials (CENTRAL) were analyzed. The search depth is five years (2018–2022 and one month in 2023).

Results. TMTD reduce the frequency and severity of symptoms, including urinary incontinence, and reduce the severity of POP, including in postpartum patients. Their effectiveness is comparable to surgical treatment. The use of a digital therapeutic device results in significantly greater improvements in quality of life measures and is similar in effectiveness to biofeedback therapy. Pessaries and TMTD are equally effective on POP symptoms and quality of life, as well as sexual dysfunction, and their combination increases the number of women experiencing improvement. The size of the genital fissure and the stage of PTO decrease as the duration of its use increases. 72% of women who used a pessary subsequently refuse surgery. Pessaries are the most cost-effective intervention.

Conclusion. Conservative treatment of POP, including TMTD and gynecological pessaries, is an effective strategy and is recommended as first-line treatment in primary care and for patients in whom surgical treatment is not an option.

Journal “Issues of practical colposcopy. Genital infections" No. 1_2023

https://drive.google.com/file/d/137JZhJmdppROCPcjVUYpIBpS7lp-6CyZ/view
Gynecology
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