Abstract
Objective: An aging population has resulted in higher prevalence of urinary incontinence (UI) and pelvic organ prolapse (POP). This study examines a nurse-run clinic and analyzes the factors contributing to successful pessary use. Study design: A retrospective chart review of 1,216 patients was completed. History, pelvic examination and pessary fitting was done. Data was analyzed utilizing a categorical model of maximum-likelihood estimation to investigate relationships. Results: Median patient age was 63 years. Median number of pessaries tried was two. Eighty-five percent of post-menopausal women were on hormone replacement therapy (HRT) prior to fitting. Highest success rate of 78% was in the group on both systemic and local HRT. Success rates ranged from 58% for urge incontinence to 83% for uterine prolapse. Prior vaginal surgery was a factor impacting success. In our series highest success rates for fitting were obtained with ring pessaries, ring with support, and gellhorns. Conclusions: This model is a viable, option for the conservative management of UI and POP. Local HRT plays an important role in successful pessary fitting. Complications are rare.
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References
Hill K (1996) The demography of menopause. Maturitas 23:113–127
Bhatia NN, Bergman A (1985) Pessary test in women with urinary incontinence. Obstet Gynecol 65:325–327
Maubon AJ, Boncoeur-Martel MP, Juhan V, Courtieu CR, Thurmond AS, Aubas P, Mares P, Rouanet JP (2000) Static and dynamic MRI of a urinary control intra-vaginal device. Eur Radiol 10:879–884
Hextall A, Boos K, Cardozo L, Toozs-Hobson P, Anders K, Khullar V (1998) Videocystourethrography with a ring pessary in situ: a clinically useful preoperative investigation for continent women with urogenital prolapse. Int Urogynecol J 9:205–209
Poma PA (2000) Nonsurgical management of genital prolapse: A review and recommendations for clinical practice. J Reprod Med 45(10):789–797
Pott-Grinstein E, Newcomer JR (2001) Gynecologists’ patterns of prescribing pessaries. J Reprod Med 46(3):205–208
Davila GW (1996) Vaginal prolapse: management with nonsurgical techniques. Postgrad Med 99(4):171–185
Wu V, Farrell SA (1997) A simplified protocol for pessary management. Obstet Gynecol 90(6):990–994
Farrell SA (2001) Pessaries for the management of stress urinary incontinence. J Obstet Gynecol 23(12):1184–1189
Nygaard IE (1995) Prevention of exercise incontinence with mechanical devices. J Reprod Med 40(2):89–94
Palumbo MV (2000) Pessary placement and management. Ostomy/Wound Manag 46(12):40–45
Sulak PJ, Kuehl TJ, Shull BL (1993) Vaginal pessaries and their use in pelvic relaxation. J Reprod Med 38(12):919–923
Flood CG, Hanson LAM (2003) Support devices. In: Drutz HP, Herschorn S, Diamant NE (eds) Female pelvic medicine and reconstructive pelvic surgery. Springer-Verlag, London, pp 289–298
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Hanson, LA.M., Schulz, J.A., Flood, C.G. et al. Vaginal pessaries in managing women with pelvic organ prolapse and urinary incontinence: patient characteristics and factors contributing to success. Int Urogynecol J 17, 155–159 (2006). https://doi.org/10.1007/s00192-005-1362-x
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DOI: https://doi.org/10.1007/s00192-005-1362-x