Choice of pelvic organ prolapse surgery: Vaginal or abdominal, native tissue or synthetic grafts, open abdominal versus laparoscopic or robotic

摘要

Women with symptomatic pelvic organ prolapse (POP) and their doctors have an increasing number of options and surgical choices. Conservative treatment with a vaginal pessary will successively reduce POP and treat symptoms in most cases, but the patient will require lifetime care of the pessary including regular cleaning and replacement. Surgery is an effective treatment but has operative morbidity and a recurrence rate. The risks of surgery will vary with the type of operation performed. In theory at least, operation selection should be based on what suits the needs of the patient best: what is the most effective and safest way to surgically correct her POP? This is not a simple matter, as what may be more effective may have a higher morbidity.