Successful Use of Ring Pessary with Support for Advanced Pelvic Organ Prolapse

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2015 May 19

PMID 25982787

Citations 9

Authors

Jing Ding

Chun Chen

Xiao-Chen Song

Lei Zhang

Mou Deng

Lan Zhu

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: Support pessaries are not recommended for patients with advanced prolapse. This study aimed to explore the efficacy of the ring pessary with support for the treatment of advanced pelvic organ prolapse (POP).

Methods: We conducted this prospective study on pessary fittings performed between November 2013 and September 2014 at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing. A total of 109 patients with stage III or IV POP completed a detailed history. A successful fitting was defined as the continued use of the device for over 3 months from the initial fitting. Data were analyzed with the Wilcoxon rank-sum test, independent sample t tests, continuity correction χ(2) tests, and Fisher's exact test.

Results: A total of 74.3 % (81/109) of the patients were successfully fitted with the ring pessary with support at the initial visit. Among those women with a successful initial fitting, the failure rate was less than 10 % (8/81) at 3 months. Furthermore, 82.7 % (67/81) of the patients were able to manage the pessary by themselves. Seven patients experienced vaginal erosion. There was no association of prolapse stage and the predominant prolapse compartment with pessary trial outcome. The average vaginal length of the patients with successful pessary use was 7.58 cm.

Conclusions: The ring pessary with support was successfully fitted in patients with advanced POP with a high success rate and few complications. Older patients were more likely to prefer the ring pessary with support due to its convenient use.

Citing Articles

Characteristics and outcomes of patients with pelvic organ prolapse: an analysis of data from Mulago National Referral Hospital from 2007-2016.

Byamugisha J, Justus B, Kakaire O, Haddy N, Susan O, Korn A Afr Health Sci. 2023; 23(1):410-416.

PMID: 37545968 PMC: 10398439. DOI: 10.4314/ahs.v23i1.43.

Outcomes of pessary fitting trials for patients with stage IV pelvic organ prolapse: a prospective study.

Zhou Y, Sun T, Ju A, Zhu L Int Urogynecol J. 2023; 35(1):59-67.

PMID: 37542565 PMC: 10810943. DOI: 10.1007/s00192-023-05594-2.

Pessary with perineal suture for treatment of pelvic organ prolapse: description and benefit of the technique.

Perez-Febles M, De-Miguel-Manso S, Garcia-Garcia E, Lopez-Pais M, Cuaresma-Gonzalez M, Ibanez-Nieto M Arch Gynecol Obstet. 2022; 307(3):789-795.

PMID: 36242614 PMC: 9984320. DOI: 10.1007/s00404-022-06739-2.

Parameters associated with unsuccessful pessary fitting for pelvic organ prolapse up to three months follow-up: a systematic review and meta-analysis.

Manzini C, Morsinkhof L, Huub van der Vaart C, Withagen M, Grob A Int Urogynecol J. 2022; 33(7):1719-1763.

PMID: 35037973 PMC: 9270314. DOI: 10.1007/s00192-021-05015-2.

Vaginal Pessaries for Pelvic Organ Prolapse or Stress Urinary Incontinence: A Health Technology Assessment.

Ont Health Technol Assess Ser. 2021; 21(3):1-155.

PMID: 34055111 PMC: 8129636.

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