Workshop on cultivating shared decision making to improve surgical outcomes for pelvic organ prolapse

Abstract

This invited Workshop addressed the treatment of pelvic organ prolapse (POP) through the lens of a shared decision-making framework, based on individual discussions to balance benefits and risks of POP treatment. The framework begins with a consideration of bothersome symptoms as the basis for intervention, and highlights new research to investigate the relationship between POP symptoms and specific anatomical defects. This is followed by a consideration of treatment options including observation, pessaries, and surgery, offering a logical progression. We further consider surgery, focusing on surgical approach and uterine preservation as variables that influence benefits and risks of surgery. Finally, we consider individual variables that further modify specific benefit/risk ratios for a given patient and treatment modality. The goal is to provide a framework that incorporates all of these parameters into evidence informed discussion.

Keywords

• Pelvic organ prolapse
• Pessary
• Surgery
• Hysteropexy