Effectiveness of a continuous-use ring-shaped vaginal pessary without support for advanced pelvic organ prolapse in postmenopausal women
| Autor: | Alessio Miceli, José Luis Dueñas |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Vaginal discharge
Pessary medicine.medical_specialty Time Factors Urology Severity of Illness Index Pelvic Organ Prolapse 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Continuous use medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Adverse effect Aged Aged 80 and over 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Contraceptive Devices Female Middle Aged Pessaries Vaginal ring Surgery Postmenopause Exact test Treatment Outcome Spain Vagina Female medicine.symptom business |
| Zdroj: | International urogynecology journal. 29(11) |
| ISSN: | 1433-3023 |
| Popis: | There is considerable variation in the clinical management of pessaries. This study was aimed at exploring the efficacy of the continuous use of ring pessaries without support for the treatment of advanced pelvic organ prolapse (POP) in nonhysterectomized postmenopausal women. We conducted this prospective study of fitted pessaries between January 2013 and June 2015 in the Department of Obstetrics and Gynecology at Macarena Hospital, Seville University, Spain. A total of 171 nonhysterectomized postmenopausal patients with symptomatic POP (stages III and IV) were counseled for two treatment options: either surgery or vaginal pessary. A total of 94 patients who agreed to use the vaginal ring pessary were included. A successful fitting was defined as the continued use of the device until the end of the study (a median 27-month follow-up). The data were analyzed with continuity correction tests, Mann–Whitney U tests, and Fisher’s exact test. Pessary use was continued by 80.8% of the patients. Most discontinuations (50.0%) occurred within the first week after device insertion. The adverse events rate was 31.6%, and all adverse events were Clavien–Dindo grade I. The complications were extrusion of the pessary (18.4%), bleeding or excoriation (10.5%), and pain or vaginal discharge (2.6%). No major complications occurred. The ring pessary without support was successfully fitted in patients with advanced POP, resulting in a high success rate. There were few side effects and complications associated with continuous use of this pessary without periodic removal or replacement. |
| Databáze: | OpenAIRE |
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