How Often Should Ring Pessaries Be Removed or Changed in Women with Advanced POP? A Prospective Observational Study

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2021 Feb 23

PMID 33620536

Citations 4

Authors

Alessio Miceli

Manuel Fernandez-Sanchez

Jose-Luis Duenas-Diez

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: This study aimed to evaluate the efficacy and safety of ring pessaries under continuous use for > 2 years. Our starting hypothesis was that their use without periodic removal, cleaning or replacement for between 24 to 48 months after insertion is safe and effective.

Methods: This was a prospective observational and descriptive study. One hundred one women who successfully completed the 24 first months of continuous use of a ring pessary were included and monitored for another 24 months. The objectives were to establish the percentage of patients maintaining its use 48 months after insertion, the reasons for discontinuation and the adverse events. Another purpose of this study was to determine the timing of replacement of the vaginal pessary in long-term users.

Results: Of the women, 92.1% (93/101) had successful pessary use, and it was discontinued by three patients (2.9%, 3/101); 76.2% (77/101) of the women continued pessary use after the end of the study, and in 16 (15.8%, 16/101) patients, after pessary removal, the prolapse disappeared and did not recur. Forty-five women (48.4%, 45/93) presented some adverse events that required temporary pessary removal. The most common one was an increase in vaginal discharge (73.3%, 33/45). In four women (8.9%, 4/45), the ring pessary was detected embedded in the vaginal epithelium.

Conclusions: Continuous use of a ring pessary can be recommended for 2 years in hysterectomized women and for 4 years in non-hysterectomized women if there are no complications.

Citing Articles

A randomized controlled study comparing the objective efficacy and safety of a novel self-inserted disposable vaginal prolapse device and existing ring pessaries.

Ziv E, Erlich T Front Med (Lausanne). 2023; 10:1252612.

PMID: 37822469 PMC: 10562599. DOI: 10.3389/fmed.2023.1252612.

Pessaries for pelvic organ prolapse: evaluation of vaginal discharge and pain during pessary cleaning in an outpatient setting.

Kruyt L, van der Ploeg J, Lammers K, van Etten-Debruijn B, Niemeijer A, Hakvoort R Int Urogynecol J. 2023; 35(2):333-339.

PMID: 37796331 DOI: 10.1007/s00192-023-05648-5.

Novel, disposable, self-inserted, vaginal device for the non-surgical management of pelvic organ prolapse: efficacy, safety, and quality of life.

Ziv E, Erlich T BMC Womens Health. 2022; 22(1):459.

PMID: 36401271 PMC: 9673387. DOI: 10.1186/s12905-022-02057-6.

The impact on complication rates of delayed routine pessary reviews during the COVID-19 pandemic.

McNeill E, Lucocq J, Brown K, Kay V Int Urogynecol J. 2022; 34(6):1219-1225.

PMID: 36040505 PMC: 9426366. DOI: 10.1007/s00192-022-05333-z.

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