Primary treatment of vaginal prolapse: Pessary use versus prolapse surgery.

ROK is a randomized controlled trial of pessary use versus prolapse surgery in patients with POP-Q stage 2-4 pelvic organ prolapse who are eligible for both treatments. The primary outcome is disease specific quality of life. Secondary outcomes are general quality of life, satisfaction, anatomical results and successful continuous pessary use.

Whether the use of pessary therapy is successful against vaginal prolapse or not might be predictable. A higher age of the patient at baseline, and succeeding pessary therapy for the period of one month is plausible associated with prolonged pessary use. On the other hand, discomfort of pessary use during the first month could be associated with failure of pessary therapy. Furthermore a certain sexual activity level and a preference for prolapse surgery might predict the failure rate.

1. Pre-treatment: POP-Q and questionnaire;

2. 6 weeks post treatment: Questionnaire;

3. 6 months post treatment: Questionnaire;

4. 1 years post treatment: POP-Q and questionnaire.

Pessary:

1. Portex;

2. Falk.



Prolapse surgery:

1. Vaginal hysterectomy;

2. Anterior colporrhaphy;

3. Posterriorcolporrhaphy;

4. A combination of above-mentioned surgical treatments;

5. A combination of above-mentioned surgical treatments including MESH material.