Abstract
The aim of this retrospective cohort study was to describe the use of incontinence pessaries in 239 women presenting to a tertiary referral center with symptoms of stress or mixed urinary incontinence. The mean age of the group was 57.4 years and mean body mass index 31.1 kg/m2. We offered pessaries to 190 of 239 women, of whom 119 (62.6%) chose to undergo fitting. Most women (89.1%) achieved a successful fit. Of 106 women who took a pessary home to manage their incontinence, we were unable to contact six for follow-up. Fifty-five women used the pessary for at least 6 months (median duration 13.0 months, range 6–30), but 45 discontinued use before 6 months (median duration 1.0, range 0.03–4). Women with pulmonary disease and those who used diuretic medications were more likely to use pessaries for longer than 6 months, but no other differences between these groups were found. Pessaries appear to be an acceptable treatment option for stress and mixed urinary incontinence in that most women are willing to consider the option, and half of those successfully fitted continue use for at least 6 months.
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Editorial Comment: The authors offer us a significant experience with pessary use in patients with stress urinary incontinence. The information should serve as an aid to clinicians who try to explain the likely outcome of pessary use to similar patients of their own. This information is nearly unique in the literature. The one suggestion that I would make is that a urinalysis or culture and a residual urine measurement be performed before pessary fitting and after the pessary has been used for a time as routine pre- and post-therapeutic measures.
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Donnelly, M.J., Powell-Morgan, S., Olsen, A.L. et al. Vaginal pessaries for the management of stress and mixed urinary incontinence. Int Urogynecol J 15, 302–307 (2004). https://doi.org/10.1007/s00192-004-1163-7
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DOI: https://doi.org/10.1007/s00192-004-1163-7