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Feasibility of using pessaries for treatment of pelvic organ prolapse in rural Nepal
Author(s) -
Robert Magali,
Govan A. Jane,
Lohani Uma,
Uprety Aruna
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12061
Subject(s) - medicine , pessary , confidence interval , obstetrics , odds ratio , logistic regression , discontinuation , cohort , cohort study , gynecology , surgery
Objective To evaluate the acceptability, feasibility, and outcomes of pessary fitting in rural Nepali communities. Methods A 1‐year prospective cohort study was conducted in the Ramechhap district of Nepal in January 2013–January 2014 among women attending a free gynecology health camp. All women with symptomatic pelvic organ prolapse ( POP ) were offered ring pessaries. Demographic information was collected and questionnaires on POP were completed. A urogynecologic examination was performed. At the 1‐year follow‐up, women were questioned on pessary use and underwent an examination. Logistic regression was used to identify associations. Results In total, 411 women attended the health camps, of whom 142 presented with symptomatic POP . Initial fitting was accomplished for 134 (94.4%) of the women. At the 1‐year follow‐up, 130 (97.0%) women in the cohort were evaluated, and 72 (55.4%) were still using the pessary. The primary reason for discontinuation was the pessary falling out (35/58, 60.3%). The most common complication was vaginal erosion (18/130, 13.8%), observed exclusively among postmenopausal women. Postmenopausal status was a predictor of continued use (odds ratio 3.12, 95% confidence interval 1.45–6.72; P =0.004). Conclusion Pessaries were found to be an acceptable and feasible option with minimal complications for treating POP in rural Nepal.