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Cross sectional study on assessment of ring pessary cleaning and removal every six months: adverse events and complications

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Abstract

Introduction and hypothesis

Despite its frequent use, there is little evidence of adequate management of pessaries for treating pelvic organ prolapse (POP). Thus, the aims the study were to assess the rate of complications in women using ring-type pessaries with cleaning and monitoring every 6 months and to correlate the time of use of the pessary with possible complications.

Methods

This is a cross-sectional study including women diagnosed with stage 3 or 4 genital prolapse, who were already in outpatient follow-up and who used a ring pessary. We excluded patients using another type of pessary, with severe comorbidities and with POP-Q ≤ 2 staging. The chi-square test or Fisher exact test was applied for categorical variables, the t-test for continuous variables with normal distribution and Mann-Whitney test for non-parametric variables.

Results

A total of 83 women using a ring pessary were assessed. The mean in months of pessary use was 31.8 ± 14.9 months. Vaginal discharge was the most frequent complaint representing 26.5%, followed by foul smell in 13.3%. No significant correlation was found between length of pessary use and clinical variables. However, a significant correlation was found between immediate complications and the length of pessary use (21.3 ± 5.9 months; p < 0.0044).

Conclusion

There was no increase in complication rate in the continuous use of a ring pessary with cleaning and monitoring every 6 months. Determining a follow-up time that reduces the risk of complications is necessary not only for the organization of the attendance services, allowing a greater number of monitored patients, but also for the access of patients who need regular monitoring.

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Funding

GMVP-Grant 2019/26723–5, São Paulo Research Foundation (FAPESP).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, CAISM-Division of Gynecology-Rua Alexander Fleming 101, Cidade Universitária, Campinas, 13083-881, Brazil

    Suelene Costa de Albuquerque Coelho, Gláucia Miranda Varella Pereira, Luiz Gustavo Oliveira Brito & Cássia Raquel Teatin Juliato

Authors
  1. Suelene Costa de Albuquerque Coelho
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  2. Gláucia Miranda Varella Pereira
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  3. Luiz Gustavo Oliveira Brito
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  4. Cássia Raquel Teatin Juliato
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Contributions

SCAC: Project development, Data Collection, Manuscript writing.

GMVP: Data analysis, Manuscript writing, Manuscript Edition.

LGOB: Data analysis, Manuscript writing, Manuscript Edition.

CRTJ: Project development, Data analysis, Manuscript writing, Manuscript Edition.

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Correspondence to Cássia Raquel Teatin Juliato.

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de Albuquerque Coelho, S.C., Pereira, G.M.V., Brito, L.G.O. et al. Cross sectional study on assessment of ring pessary cleaning and removal every six months: adverse events and complications. Int Urogynecol J 33, 397–403 (2022). https://doi.org/10.1007/s00192-021-04775-1

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  • DOI: https://doi.org/10.1007/s00192-021-04775-1

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