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Long-Term Compliance of Self-Care Pessary in Symptomatic Pelvic Organ Prolapse

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Abstract

Introduction and Hypothesis

Continuation of using a pessary for the treatment of pelvic organ prolapse (POP) is important for improving symptoms but the data on long-term compliance is very limited. Therefore, we conducted this study aimed at evaluating the compliance of patients in the long-term use of a pessary.

Methods

The medical records of women with symptomatic POP were retrospectively reviewed to recruit cases opting for pessary use. The inclusion criteria were women who had a successful pessary fitting and completed at least 5 years of follow-up. Exclusion criteria were pregnancy, death during the follow-up period, and loss to follow-up. Demographic data, pelvic organ prolapse stage, associated symptoms, type and size of pessary, and reason for discontinuation were reviewed.

Results

A total of 261 patients opted for pessary use. Of them, 88.9% (231 out of 261) were successful in initial pessary fitting and 54 were excluded for various reasons. The remaining 178 patients were available for analysis. The continuation rate of self-care pessary at the 5-year follow-up was 53.93% (96). The discontinuation rate was 46.07% (82). The main reasons for discontinuation were desire for surgery (39.1%) and discomfort (31.7%). The highest rate of discontinuation (46.63%) was found in the 1st year of follow-up. The significant risk factors of discontinuation included digitation symptoms on univariate analysis and prior hysterectomy on multivariate analysis, with an odds ratio (95% CI) of 5.98 (1.56–22.88).

Conclusions

Among Thai women, the adherence to self-care pessary in symptomatic pelvic organ prolapse at the 5-year follow-up was 53.93%. The main reason for discontinuation was a prior hysterectomy.

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Data Availability

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Divison of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Sasivimol Srisukho, Chailert Phongnarisorn & Yanika Rujijanakul

  2. Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Nattaphol Charoenloet & Theera Tongsong

Authors
  1. Nattaphol Charoenloet
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  2. Sasivimol Srisukho
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  4. Theera Tongsong
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Contributions

N.C.: project development, data collection, manuscript writing/editing; S.S.: project development, data collection, data analysis, manuscript writing/editing; C.P.: project development, manuscript writing/editing; T.T.: data analysis, manuscript writing/editing; Y.R.: data collection.

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Correspondence to Sasivimol Srisukho.

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Charoenloet, N., Srisukho, S., Phongnarisorn, C. et al. Long-Term Compliance of Self-Care Pessary in Symptomatic Pelvic Organ Prolapse. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05806-3

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