Pelvic floor muscle training versus watchful waiting or pessary treatment for pelvic organ prolapse (POPPS): Design and participant baseline characteristics of two parallel pragmatic randomized controlled trials in primary care

Introduction and hypothesisPelvic organ prolapse is a common condition. There is inconsistency between predictors of unsuccessful pessary fitting in urological/gynaecological clinics. Research in general practice is scarce. The aim was to estimate the proportion of women in general practice with a symptomatic pelvic organ prolapse and unsuccessful pessary fitting, and to identify characteristics associated with unsuccessful pessary fitting.MethodsA cross-sectional study in general practice (n = 20) was carried out among women (≥55 years) with symptomatic prolapse (n = 78). Multivariate logistic regression analysis was used to identify predictors of unsuccessful pessary fitting.ResultsIn total, 33 women (42 %) had unsuccessful pessary fitting. Factors associated with unsuccessful pessary fitting were age (per year, OR 0.93 [95 % CI 0.87–1.00]), body mass index (per kg/m2, OR 1.14 [95 % CI 1.00–1.30]), and having underactive pelvic floor muscles (OR 2.60 [95 % CI 0.81–8.36]).ConclusionsPessary fitting was successful in 58 %, indicating that pessary treatment may be suitable for many, but not for all women in general practice with symptomatic prolapse. The condition of the pelvic floor probably plays a role in the success of pessary fitting, as demonstrated by the association with underactive pelvic floor muscles, and body mass index. The association with age may reflect the higher acceptance of conservative treatments for prolapse in older women. This is the first study on predictive factors for unsuccessful pessary fitting in general practice. Therefore, further research should seek to confirm these associations before we can recommend the use of this information in patient counselling.

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“…All participants provided written informed consent. An extensive description of the design is provided elsewhere [18]. …”

Section: Methodsmentioning

confidence: 99%

Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice

et al. 2016

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“…16 Data were collected during the baseline assessment prior to randomisation and concerned women both with and without a pelvic organ prolapse.…”

Section: Methods Study Design and Participantsmentioning

confidence: 99%

Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice

et al. 2014

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BackgroundPelvic floor symptoms are common and are negatively associated with sexual function which, in turn, is an important aspect of quality of life. The majority of older women with pelvic floor symptoms are treated in general practice but evidence from studies in general practice on the sexual functioning of these women is scarce. AimThis study examined predictors of sexual inactivity in older women with pelvic floor symptoms in general practice and of sexual functioning in those women who are sexually active. Design and settingCross-sectional study in women (aged ≥55 years) from 20 general practices who screened positive on a pelvic floor symptom questionnaire. MethodLogistic and linear regression analyses were used to determine predictors of sexual inactivity and sexual functioning (PISQ-12) by assessing their association with patient characteristics, symptoms (PFDI-20) and degree of prolapse (POP-Q). ResultsA total of 639 women were included (sexually active n = 393, sexually inactive n = 246). Predictors of sexual inactivity were increasing age (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.10 to 1.17) and lower education (OR = 2.31; 95% CI = 1.50 to 3.54; Nagelkerke R 2 = 0.208). In sexually active women, sexual functioning was associated with pelvic floor symptom distress (P<0.001) and pelvic floor surgery (P = 0.018; R 2 = 0.138). ConclusionIn older women with pelvic floor symptoms, increasing age and lower educational level are predictors of sexual inactivity. Many of these older women are sexually active and pelvic floor symptom distress is negatively associated with sexual functioning. These results may encourage GPs to ask about sexual problems in women with pelvic floor symptoms.

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“…All participants gave written informed consent. The study protocol 11 and short-term results 12 have been reported previously.…”

Section: Design and Settingmentioning

confidence: 99%

Two‐year effects and cost‐effectiveness of pelvic floor muscle training in mild pelvic organ prolapse: a randomised controlled trial in primary care

Panman

Wiegersma

Kollen

et al. 2016

BJOG

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Pelvic floor muscle training versus watchful waiting or pessary treatment for pelvic organ prolapse (POPPS): Design and participant baseline characteristics of two parallel pragmatic randomized controlled trials in primary care

Cited by 26 publications

References 23 publications

Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice

Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice

Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice

Two‐year effects and cost‐effectiveness of pelvic floor muscle training in mild pelvic organ prolapse: a randomised controlled trial in primary care

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