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Women referred with moderate to severe POP symptoms and POP stage \u2265 2 were included and chose either pessary therapy or surgical intervention. The PISQ-IR was filled in at baseline and 24-months, the delta of change was calculated and compared between both groups. Multivariate linear regression was performed to adjust for potential confounding factors in the association between the summary score of the PISQ-IR and therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Change in PISQ-IR between pessary and surgical intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The delta of change at 24-months was calculated for 198 women in the pessary group and 129 women in the surgery group. SA women in the surgery group reported statistically significant more improvement on the condition-specific (-0.19 95%CI -0.35; -0.03, P = .02), and condition-impact (-0.48 95%CI -0.69; -0.28, P &amp;lt; .001) domains as well as on the summary score (-0.15 95%CI -0.23; -0.08, P &amp;lt; .001) as compared to the pessary group. No significant differences between pessary and surgery were found on the domains for NSA women. After controlling for potential baseline confounders, surgery still had a statistically significant effect on the summary score (B = 0.08; 95%CI interval 0.007\u20130.15, P = .03). Women having surgery had 2.62 times higher odds of changing from NSA to SA than pessary therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical implications<\/jats:title>\n                  <jats:p>SA women who clearly express that POP-related symptoms limit their sexual functioning should be counseled that surgery results in a more remarkable improvement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>Our strengths include the large sample size, long-term follow-up, the use of the PISQ-IR as a validated outcome tool evaluating both SA and NSA women, and this study reflects real-life clinical practice that enhances the external validity of the findings. A limitation of our study is the considerable proportion of non-responders at 24-months follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Sexual function in SA women with POP is superior in case surgery is performed as compared to pessary therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2021.11.008","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T12:44:48Z","timestamp":1640609088000},"page":"270-279","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Female Sexual Functioning in Women with a Symptomatic Pelvic Organ Prolapse; A Multicenter Prospective Comparative Study Between Pessary and Surgery"],"prefix":"10.1093","volume":"19","author":[{"given":"Lisa R.","family":"van der Vaart","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"Vollebregt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Spaarne Gasthuis , Hoofddorp , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bente","family":"Pruijssers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, UMCU, University of Utrecht , Utrecht , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo L.","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Reinier de Graaf Hospital , Delft , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine L.","family":"Lagro-Janssen","sequence":"additional","affiliation":[{"name":"Department of General Practice\/ Women\u2019s Studies Medicine, University Medical Centre Radboud , Nijmegen , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan-Paul W.R.","family":"Roovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"},{"name":"Department of Gynaecology, Bergman Clinics , Amsterdam , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl H.","family":"van der Vaart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, UMCU, University of Utrecht , Utrecht , the Netherlands"},{"name":"Department of Gynaecology, Bergman Clinics , Hilversum , the 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