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A prospective study of pessary use for severe pelvic organ prolapse: 3-year follow-up outcomes

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To estimate the optimal definition of successful pessary use and the long-term success rate of the pessary as well as the complications and factors associated with continued pessary use.

Methods

Consecutive patients who had symptomatic stage III/IV POP were enrolled. The degrees of POP were assessed by POP-Q. All patients completed the PFIQ-7 questionnaire before pessary use. For the 1-week, 1-month, 3-month, 6-month, 1-year and 3-year follow-up assessments, patients visited the clinic for an examination and to complete the questionnaire. SPSS 18.0 was used for the data analysis. Wilcoxon's signed-rank test was performed to estimate the change in PFIQ-7 scores before and after pessary use. Logistic regression was performed to identify the factors associated with the duration of pessary use.

Results

A total of 60 subjects (average age 68.93 ± 8.98 years) were enrolled. The 3-year success rate of the pessary was 63.33%. The PFIQ-7 score in the 1-month follow-up was significantly decreased (16.22 ± 12.81 vs 1.39 ± 3.39, P = 0.000). During the follow-up, none of the patients experienced any severe complications, and the rate of vaginal erosion was 20% (12/60). The PFIQ-7 score in the 1-month follow-up decreased more than 50% and was associated with continuous pessary use [OR 20.75, P = 0.027, 95% CI (2.28, 189.27)].

Conclusions

Successful pessary use can be defined as fitting for longer than 3 months. The PFIQ-7 scores should be focused on during the follow-up. The treatment should be changed if the scores decrease less than 50% in the 1-month follow-up.

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Acknowledgements

This work was supported by grants from the National Natural Science Foundation of China (81501238).

Funding

This work was supported by grants from the National Natural Science Foundation of China (81501238).

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Authors and Affiliations

  1. Department of Gynecology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, People’s Republic of China

    Bin Li, Jing Zhang, Cuige Yu, Lu Zhang & Lihong Chen

  2. Department of Burns and Cutaneous Surgery, the First Affiliated Hospital of the Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China

    Qiaohua Chen

Authors
  1. Bin Li
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  2. Qiaohua Chen
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  3. Jing Zhang
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  4. Cuige Yu
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  5. Lu Zhang
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  6. Lihong Chen
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Contributions

BL: project development, data collection, manuscript writing. QHC: project development, data analysis; manuscript writing. JZ: data collection, manuscript writing. CGY: data collection, manuscript editing. LZ: data collection, data analysis. LHC: project development, manuscript editing.

Corresponding author

Correspondence to Lihong Chen.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the institutional ethics committee of Shaanxi provincial people’s hospital. All participants gave the verbal and signed consent.

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Informed consent was obtained from all individual participants included in the study.

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Li, B., Chen, Q., Zhang, J. et al. A prospective study of pessary use for severe pelvic organ prolapse: 3-year follow-up outcomes. Arch Gynecol Obstet 301, 1213–1218 (2020). https://doi.org/10.1007/s00404-020-05526-1

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  • DOI: https://doi.org/10.1007/s00404-020-05526-1

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