Maryam Hajihashemy - Assistant professor, Isfahan University of Medical Sciences,Beheshti Hospital, Isfahan, Iran
Elham Gholamian - Isfahan University of Medical Sciences, Isfahan, Iran
Samaneh Tarokh - Isfahan University of Medical Sciences, Isfahan, Iran
Fedyeh Haghollahi - Vali ASR Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

Background and Aim : The women with utero vaginal prolapse are managed, by surgery or pessaryplacement. This study aimed to compare the Lefort colpocleisis surgery and pessary insertion clinicaloutcomes in patient with advanced pelvic organ prolapse(POP).Methods : The present study is a non-randomized, semi experimental clinical trial. The population understudy was 110 elderly women who had a diagnosis of stage III or higher pelvic organ prolapse accordingto the POP quantification (POP-Q) system who have been undergoing Le Fort colpocleisis surgery orpessary placement in University Clinics (beheshti hospital or alzahra hospital) from November 2016 toJanuary 2018. One- hundred-ten candidate entered the study into two groups of intervention (Le fortColpocleisis surgery, n=55) and control (Pessary placement, n=55). All patients completed the Pelvic FloorDistress Inventory Questionnaire (PFDI-20) before and six months after the intervention. The mainoutcome measurements were the pelvic prolapse manifestation symptom and clinical outcomes in twogroups.Results : The mean age in control and intervention group were 68.98((± 8.79) and 64.76(± 7.04) years old,respectively (p=0.006). The prolapse symptoms was improved after the treatment in each group (p<0.001)But,In the two groups of control and intervention ,the total of Pelvic Floor Distress Inventory score (PFDI)was no difference after the end of treatment (P=0.19)Conclusion : A strategy of pessary treatment or a strategy with surgery both seems to be effective optionsfor the treatment of elderly women with stage III or higher of pelvic organ prolapse(POP).These outcomescan help with treatment options and allow better guidance to elderly patients with symptomatic POP in thetreatment decision process.

Modified LeFort Colpocleisis, Pelvic floor reconstructive surgery, Pelvic organ prolapse, pessary