New study explores surgical treatment options for women with prolapse

Researchers from Glasgow Caledonian University’s Research Centre for Health (ReaCH) are involved in a new study exploring surgical treatment options for women with pelvic organ prolapse.

Half of all women will experience pelvic organ prolapse in their lifetime. When the pelvic floor muscles work well, they hold the bladder, bowel, and vagina in the right position but when problems arise, the womb can bulge or hang down into the vagina.

This type of prolapse is known as apical prolapse. There are currently two main types of surgery colpocleisis and sacrospinous fixation available to repair apical prolapse.

Colpocleisis involves pushing the prolapse back inside the pelvis and closing the top of the vagina. This is the simpler of the two surgeries but will remove a woman’s ability to have penetrative vaginal intercourse. The more complex surgery, sacrospinous fixation, avoids this problem by stitching the top of the vagina to a ligament in the pelvis. There is currently little evidence to indicate which surgery is the better option.

The new study is being led by Dr Laura Jones, from the Institute of Applied Health at the University of Birmingham, in collaboration with Glasgow Caledonian University, University of Exeter, University of West of Scotland, Birmingham Women’s and Children NHS Trust, University Hospitals Plymouth NHS Trust and Royal College of Obstetricians and Gynaecologists.

The multi-method feasibility study, funded by the National Institute of Health and Social Care Research Health Technology Assessment, will involve discussions with women and the clinicians who care for them to understand treatment decisions and preferences around surgical options for pelvic organ prolapse.

Researchers are also working closely with patient partners and a patient advisory group to explore whether it is possible to conduct a study comparing the two surgical treatment options, via a clinical trial, in the future.

Women and clinicians will be identified from across the UK through NHS clinics, local community groups, national women’s voice groups and charities, to ensure that the researchers hear from those with different views and experiences.

Clinicians will also keep track of the number of women with apical prolapse, who they see in their clinics over a six-month period, that would be eligible for a future trial of the two different types of surgery.

Glasgow Caledonian Professor of Nursing Carol Bugge and Research Fellow Dr Melanie Dembinsky, from the School of Health and Life Sciences Research Centre for Health (ReaCH) are involved in the study.

Professor Bugge said: “The study aims to use new Complex Interventions Guidance to understand if it is possible to develop a clinical trial that compares the two different surgeries. In the longer term the aim is to support the best possible health care for women with pelvic organ prolapse.”