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

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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.


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.


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).


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



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).

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