Abstract
The objective of this study was to evaluate characteristics, satisfaction degree, and problems of patients using a pessary for pelvic organ prolapse. A total of 104 patients who had been fitted with a pessary and available for follow-up for pelvic organ prolapse management were enrolled. The patients answered questions on general characteristics, indications for pessary use, complications from pessary use, satisfaction degree, and frequency of removal. The results indicated that 76 (73.0%) patients had at least more than one medical illness and 86 (82.7%) patients complained of lower urinary symptoms such as incontinence, urgency, frequency, or nocturia. Eighty-four (80.7%) patients used pessaries as they were not surgical candidates due to poor medical status or old age. After using a pessary, 76 (73.1%) patients had symptoms such as bleeding, erosion, or foul odor; 70.2% of the women answered that they were satisfied or more than satisfied and 19.1% of the patients removed their pessaries, of whom 80.0% were unable to continue use due to repeated expulsion of the pessary and uncomfortable fitting. These data suggest that the pessary tends to be used for high-risk patients due to medical problems or old age. Despite the high frequency of complications from pessary use, it was seen that the frequency of removing the pessary was low and the satisfaction degree was high. Most of the complications were not thought to be serious. To decrease the frequency of complications, the regular follow-up visit and proper management of pessary use were thought to be needed. Further studies are warranted on tailor-fitting the pessary by variable use and relieving the symptoms associated with the lower urinary tract.
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References
de Mola JRL, Carpenter SE (1996) Management of genital prolapse in neonates and young women. Obstet Gynecol Surv 51:253–260
Bash KL (2000) Review of vaginal pessaries. Obstet Gynecol Surv 55:455–460
Zeitlin MP, Lebherz TB (1992) Pessaries in the geriatric patient. J Am Geriatr Soc 40:635–639
Cundiff GW, Weidner AC, Visco AG, Bump RC, Addison WA (2000) A survey of pessary use by members of the American Urogynecologic Society. Obstet Gynecol 95:931–935
Bump RC, Mattiansson A, Bo K, Brubaker LP, Delancey JOL, Klarskov P (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Koduri S, Sand PK (2000) Recent developments in pelvic organ prolapse. Curr Opin Obstet Gynecol 12:399–404
Grinstein EP, Newcomer JR (2001) Gynecologists’ patterns of prescribing pessaries. J Reprod Med 46:205–208
Mills WG (1978) The management of genital prolapse. Br J Hosp Med 20:586–590
Wood NJ (1992) The use of vaginal pessaries for uterine prolapse. Nurse Pract 17:31–36
Myerscough PR (1972) Genital prolapse. Practitioner 208:470–474
Goldstein I, Wise GJ, Tancer ML (1990) A vesicovaginal fistula and intravesical foreign body: a rare case of the neglected pessary. Am J Obstet Gynecol 589–591
Davila GW (1996) Vaginal prolapse. Postgrad Med 99:171–185
Wu V, Farrell SA, Baskett TF, Flowerdew G (1997) A simplified protocol for pessary management. Obstet Gynecol 90:990–994
Roberge RJ, McCandish MM, Dorfsman ML (1999) Urosepsis associated with vaginal pessary use. Ann Emerg Med 33:581–583
Poma PA (1992) Management of incarcerated vaginal pessaries. J Am Geriatr Soc 40:635–639
Heit M, Rosenquist C, Culligan P, Graham C, Murphy M, Scott S (2003) Predicting treatment choice for patients with pelvic organ prolapse. Obstet Gynecol 101:1279–1284
Chung F, Mezei G, Tong D (1999) Adverse events in ambulatory surgery. A comparison between elderly and younger patients. Can J Anaesth 46:305–308
Roberge RJ, Keller C, Garfinkel M (2001) Vaginal pessary-induced mechanical bowel obstruction. J Emerg Med 20:367–370
Schraub S, Sun XS, Maingon P, Horiot JC, Daly N, Keiling R et al (1992) Cervical and vaginal cancer associated with pessary use. Cancer 69:2505–2509
Sulak PJ, Kuehl TJ, Shull BL (1993) Vaginal pessaries and their use in pelvic relaxation. J Reprod Med 38:919–923
Singh K, Reid WMN (2001) Non-surgical treatment of uterovaginal prolapse using double vaginal rings. Br J Obstet Gynaecol 108:112–113
Viera AJ, Pettigrew ML (2000) Practical use of the pessary. Am Fam Physician 61:2719–2726
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Editorial Comment: These authors should be commended for having added to the dearth of information about the use of pessaries and relieving POP symptoms. They had a high success rate (82%) and satisfaction rate (70%) using a ring pessary. However, their study is hampered by the fact it does not distinguish patients with a successful pessary fitting and those who no longer used a pessary. This study as with all observational studies has many flaws and leaves many unanswered questions. According to the Cochrane Database there are no randomized controlled trials in regard to treating women with pessaries. Future research efforts should focus on which symptoms of POP will be helped or worsened by pessaries as well as which type of pessary to use for the presenting POP.
Appendix: questionnaire on pessary use
Appendix: questionnaire on pessary use
We would like to find out about your pessary usage pattern and we appreciate very much your effort in helping us by filling in this questionnaire.
Please answer each question.
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Bai, S.W., Yoon, B.S., Kwon, J.Y. et al. Survey of the characteristics and satisfaction degree of the patients using a pessary. Int Urogynecol J 16, 182–186 (2005). https://doi.org/10.1007/s00192-004-1226-9
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DOI: https://doi.org/10.1007/s00192-004-1226-9