Abstract: Objective To explore factors influencing the selection of treatment strategy for patients with severe pelvic organ prolapse(POP). Methods A total of 145 patients with severe POP treated during Dec. 2020 and Mar. 2022 were selected and divided into the surgical group(n=78)and pessary group(n=67)according to the treatment strategy. The general information, scores of the modified body self-image scale(MBIS), scores of pelvic floor distress inventory short form(PFDI-20), and scores of urogenital distress inventory short form(UDI-6)were compared between the two groups. Factors influencing the selection of treatment strategies were analyzed with univariate and binary Logistic regression analyses. Results Statistically significant differences were found in body mass index(BMI), age of initial visit, course of illness, mid-pelvic POP-Q stage, complications, MBIS scores and UDI-6 scores between the two groups(P<0.001, P=0.036, P<0.001, P<0.001, P=0.005, P<0.001, P<0.001). Logistic regression showed that age of initial visit, course of illness, mid-pelvic POP-Q stage, complications, MBIS scores and UDI-6 scores were independent factors influencing the choice of different treatment modalities(P=0.006, P=0.005, P=0.019, P=0.009, P=0.001, P=0.023). Conclusion Patients who visit the clinic at an older age, have a long course of disease, severer mid-pelvic POP-Q stage, lower MBIS scores and lower urinary tract symptoms are more likely to choose surgery, while patients complicated with other diseases like to choose pessary.

Key words: Severe pelvic organ prolapse, Surgical treatment, Pessary treatment, Influencing factors