Vaginal ring pessary use for pelvic organ prolapse: continuation rates and predictors of continued use
| Autor: | Umaporn Udomsubpayakul, Sirirat Sarit-apirak, Jittima Manonai |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pessary
Adult medicine.medical_specialty General Mathematics 030209 endocrinology & metabolism Severity of Illness Index Medical Records Pelvic Organ Prolapse 03 medical and health sciences 0302 clinical medicine Severity of illness Medicine Humans Continuation rate Aged Demography Retrospective Studies Aged 80 and over Pelvic organ 030219 obstetrics & reproductive medicine business.industry Obstetrics Applied Mathematics Medical record Obstetrics and Gynecology Retrospective cohort study Middle Aged Pessaries Vaginal ring Discontinuation Administration Intravaginal Patient Compliance Female business |
| Zdroj: | Menopause (New York, N.Y.). 26(6) |
| ISSN: | 1530-0374 |
| Popis: | Objectives The aim of the study was (1) to evaluate continuation rates of vaginal ring pessary for pelvic organ prolapse (POP), and (2) to identify predictors for continued pessary use. Methods This retrospective chart review study was conducted in a tertiary center. Women who had a ring with support pessary successfully fitted between January 2009 and December 2013 and had completed up to 3 years of follow-up care were included in the analysis. Demographic and obstetric data, body weight, pelvic organ prolapse stage, and associated symptoms were evaluated. All the women were followed until February 28, 2017, unless surgery to correct POP surgery was required, pessary use was discontinued, or the women died. Results A total of 289 women with symptomatic POP (stages II, III, and IV) were evaluated. The median age was 71 years (range 34-83 y), and the median parity was 3 (range 0-8). Among the women with a successful initial fitting, the failure rate was 5.88% (17/289) at 6 months with most of these women choosing to have surgical intervention. This analysis indicates that the probability of the successful continuation of pessary use after 1, 2, 3, 4, and 5 years was 83.0%, 78.2%, 71.3%, 65.3%, and 61.7%, respectively, reported using a Kaplan-Meier plot. The main cause for discontinuation of pessary use before 3 years was the election for surgical intervention. With regard to predictors for continued pessary use, self-care was the only factor that influenced compliance rates after treatment of 3 years. Conclusion A ring with support pessary can be used successfully to alleviate symptoms of advanced stage prolapse for 3 years or longer. In addition, proper self-management was found to be a strong predictor for prolonged pessary use. |
| Databáze: | OpenAIRE |
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