(Poster 148) The Effect of Treating POP on Pelvic Pain

Objectives:

Objective: This is a prospective cohort study evaluating pelvic pain before and after treatment of pelvic organ prolapse (POP) using the Patient-reported outcomes measurement information system (PROMIS) validated National institutes of health (NIH) pain questionnaires [1].

Methods: One hundred and fifty new patients presenting with a complaint of POP at an academic institution were enrolled between April and December of 2024. Patients completed a PROMIS questionnaire before and after therapy for POP. The PROMIS questionnaire included short forms pain intensity 3a and pain interference 4a. Therapeutic options included surgery, pessary, or observation/expectant management. For analysis, the intervention group combined surgery and pessary. Pain intensity and pain interference are reported separately. PROMIS scores were calculated and a minimally important difference (MID) of four determined improvement or worsening of pain.

Results: To date, 90 patients have completed follow-up PROMIS questionnaires. At intial presentation, 36 or 41% reported the presence of pelvic pain (Table 1). Fifty patients elected for surgery, twenty elected for pessary, and twenty elected for expectant management. There was significant improvement in pain intensity and pain interference in subjects in the intervention group, but not in the expectant management group. Surgery and pessary groups have similar reports in improvement in pain (Table 2).

Conclusions:

Discussion: While pain is not a defining symptom of POP, there is data to suggest that 40-50% of patients with POP experience pelvic or back pain, and of those with pain, 70-80% feel that their pain is related to POP [2]. In patients with POP, therapeutic intervention improves pain intensity and interference in a third of patients. In patients who elected expectant management, a third noted worsening pain.

Table 1. Presence of pain or not at initial clinic visit broken down by therapeutic intervention.

Table 2. Results after comparing pre and post PROMIS questionnaires evaluated separately by short forms pain intensity 3a and pain interference 4a. * shows statistical significance.