Ring pessary for all pelvic organ prolapse.
Summary of "Ring pessary for all pelvic organ prolapse."
PURPOSE:
To evaluate the risk factors of unsuccessful fitting of ring pessary in pelvic organ prolapse (POP), continuation rate, and adverse events.
METHODS:
The ring pessary was offered to 100 symptomatic POP patients. POP was staged according to Pelvic Organ Prolapse Quantification (POP-Q) system. A successful fitting was defined as when patients continued pessary use for more than 2 weeks. Adverse events were evaluated in patients who had a successful fitting.
RESULTS:
Most patients (71%) were in POP-Q stage III-IV and 77 patients were fitted at the initial visit. Successful fitting was reported in 62 patients (62%). However, 52 patients (52%) continued to use the pessary at 13 months median follow-up. The most common reason for discontinuation was frequent pessary expulsion. Short vaginal length ≤6 cm and wide introitus >4 fingerbreadths were the significant risk factors for unsuccessful fitting. New onset of stress urinary incontinence (SUI) developed in 28.2% of patients. One third and 21% of patients had vaginal discharge and vaginal erosion, respectively. Only half of the patients could manage the pessary either by themselves or with their caregivers.
CONCLUSION:
The ring pessary fitting can be attempted in all POP cases irrespective of stage. Short vaginal length <6 cm and wide introitus >4 fingerbreadths were the risk factors for unsuccessful fitting. It has an acceptable continuation rate and manageable adverse events. The self-care of pessary is an important strategy to minimize adverse events.
Affiliation
Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand, T_manchana@hotmail.com.
Journal Details
This article was published in the following journal.
Name: Archives of gynecology and obstetrics
ISSN: 1432-0711
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20848116
- DOI: http://dx.doi.org/10.1007/s00404-010-1675-y
Medical and Biotech [MESH] Definitions
Pelvic Organ Prolapse
Abnormal descent of a pelvic organ resulting in the protrusion of the organ beyond its normal anatomical confines. Symptoms often include vaginal discomfort, DYSPAREUNIA; URINARY STRESS INCONTINENCE; and FECAL INCONTINENCE.
Pelvic Floor
Soft tissue formed mainly by the pelvic diaphragm, which is composed of the two levator ani and two coccygeus muscles. The pelvic diaphragm lies just below the pelvic aperture (outlet) and separates the pelvic cavity from the PERINEUM. It extends between the PUBIC BONE anteriorly and the COCCYX posteriorly.
Visceral Prolapse
The prolapse or downward displacement of the VISCERA.
Lesser Pelvis
The part of the pelvis, inferior to the pelvic brim, that comprises both the pelvic cavity and the part of the PERINEUM lying inferior to the PELVIC DIAPHRAGM.
Pelvic Neoplasms
Tumors or cancer of the pelvic region.
PubMed Articles
Pessary treatment for pelvic organ prolapse and health-related quality of life: a review.
Pessaries have been used to treat women with pelvic organ prolapse (POP) since the beginning of recorded history. This review aims to assess the effect of pessary treatment on the disease-specific, he...
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INTRODUCTION AND HYPOTHESIS: The aim of this study is to evaluate and compare the effectiveness of pessaries and surgery in women with symptomatic pelvic organ prolapse. METHODS: A total of 554 women...
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INTRODUCTION AND HYPOTHESIS: We performed an investigation of symptoms, quality of life (QOL), and factors affecting women's treatment choice of pelvic organ prolapse (POP). METHODS: Three hundred and...
Clinical Trials
Characteristics Predictive of Pessary Success
Pessaries are mechanical support devices worn vaginally to treat the symptoms of pelvic organ prolapse, such as vaginal pressure or a vaginal bulge. Pessaries are one of the options along...
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Pelvic organ prolapse occurs when the pelvic organs (e.g., the uterus or bladder) fall or slide down into the vagina. Pelvic organ prolapse can be corrected with surgery. Some types of s...
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