Pelvic Organ Prolapse Clinical Trial
Official title:
Uphold Versus Robotic Surgery for Pelvic Prolapse Repair: A Decision Analytic Approach
Within the general objective of investigating optimal medical techniques for pelvic prolapse repair, this study proposes to: (1) test the hypothesis that the UPHOLD procedure is more cost effective than robotic surgery for pelvic prolapse repair (2)using formal decision analysis as the comparative strategy
The cumulative incidence of pelvic organ prolapse was approximately 2% in 2001. Given the
aging demographics in the U.S., the incidence of prolapse is projected to increase to 30% or
more for women aged 60 years and older and become of greater concern to both patients and
physicians. The demand for gynecologic services is predicted to increase by more than 45% in
the next ten years. Prolapse is related to childbirth, aging, defects in collagen, and
smooth muscle structure and strength. Etiology includes intra-abdominal pressure from
obesity, with obesity becoming an ever increasing factor in the US.
Treatment Choice of Patients:
Patients choose between pessary, surgery, and expectant management based on: age, prior
prolapse surgery, preoperative pelvic pain scores, and pelvic organ prolapse severity. These
are difficult decisions for patients.
When it comes to choosing between destinctive interventions with subtle advantages and
disadvantages, patients typically want to hear their physician's views of the scientific
merits of each procedure. Informed consent becomes extremely difficult when issues of
cost-effectiveness are at hand. Thus, the proposed project.
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