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A 5‐year prospective study of vaginal pessary use for pelvic organ prolapse
Author(s) -
Lone Farah,
Thakar Ranee,
Sultan Abdul H.,
Karamalis George
Publication year - 2011
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 - 10.1016/j.ijgo.2011.02.006
Subject(s) - pessary , medicine , urogynecology , concomitant , prospective cohort study , vagina , surgery , obstetrics , gynecology , urinary incontinence
Objective To 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. Methods A 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. Results Of 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. Conclusion If 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.