A 5‐year prospective study of vaginal pessary use for pelvic organ prolapse

International Journal of Gynecology & Obstetrics - Tập 114 - Trang 56-59 - 2011
Farah Lone1, Ranee Thakar1, Abdul H. Sultan1, George Karamalis1
1Department of Obstetrics and Gynecology, Mayday University Hospital, Surrey, UK

Tóm tắt

AbstractObjectiveTo evaluate prospectively the use of vaginal pessaries for pelvic organ prolapse (POP) and to identify complications and reasons for discontinuing pessary use over a 5‐year period.MethodsA prospective observational study was conducted among all women with POP referred to the urogynecology clinic of a UK hospital between June 2002 and June 2005 who opted to use a vaginal pessary. Patients were followed‐up for 5 years.ResultsOf the 246 women who chose to use a vaginal pessary, 187 successfully retained the pessary 4 weeks after insertion. Over a 5‐year period, 36 (19.3%) of the 187 women were lost to follow‐up. Of the 151 women included in the analysis, 21 (13.9%) discontinued use at some point after 4 weeks, whereas 130 (86.1%) used the pessary successfully over 5 years. Overall, 12.1% of the women experienced minor complications (6.9% pain or discomfort, 3.2% excoriation or bleeding, and 2.0% disimpaction or constipation). Most failures (73.8%) occurred within 4 weeks of pessary insertion. After cessation of pessary use, 70 (28.5%) of the 246 women chose surgery and 10 (4.1%) chose no further treatment.ConclusionIf treatment of POP with a vaginal pessary is successful at 4 weeks, most women will continue to use the pessary over 5 years without a concomitant increase in complications.

Tài liệu tham khảo

Hagen S., 2006, Conservative management of pelvic organ prolapse in women, Cochrane Database Syst Rev, CD003882 10.1016/S0029-7844(01)01472-7 Cardozo L., 1995, Prolapse, 642 10.1016/S0140-6736(07)60462-0 KesharvarzH. HillisS.D. KiekeB.A. MarchbanksP.A..Hysterectomy surveillance—United States 1994–1999.www.cdc.govhttp://www.cdc.gov/mmwr/preview/mmwrhtml/ss5105a1.htm Published 2002 10.1016/j.ajog.2010.02.037 Piya‐Anant M., 2003, Integrated health research program for the Thai elderly: prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women, J Med Assoc Thai, 86, 509 Wilson P.D., 2005, Adult conservative management, 936 10.1136/bmj.324.7348.1258 10.1007/s00192-005-1313-6 10.1097/01.AOG.0000222903.38684.cc 10.1007/s00192-010-1340-9 10.1007/s00192-009-0991-x 10.1016/j.ajog.2007.08.013 10.1016/j.ajog.2003.10.711 10.1111/j.1471-0528.2009.02380.x 10.1016/S0002-9378(96)70243-0 10.1097/01.AOG.0000175832.13266.bb 10.1007/s00192-005-1362-x Donnelly M.J., 2004, Vaginal pessaries for the management of stress and mixed urinary incontinence, Int Urogynecol J Pelvic Floor Dysfunct, 15, 302 10.1007/s00192-006-0089-7 10.1007/s00192-008-0574-2
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Thông tin xuất bản

International Journal of Gynecology & Obstetrics

Tập 114

56-59

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