Changes in the Vaginal Microenvironment as Related to Frequency of Pessary Removal
| Autor: | Kate V. Meriwether, Deslyn T.G. Hobson, J Ryan Stewart, Casey L. Kinman, Nicole J Fregosi, Jeremy Gaskins |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pessary
medicine.medical_specialty Time Factors Urology medicine.medical_treatment Pelvic Organ Prolapse Article law.invention 03 medical and health sciences 0302 clinical medicine Primary outcome Randomized controlled trial law medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Mobiluncus Device Removal Lubricants 030219 obstetrics & reproductive medicine biology Obstetrics business.industry Obstetrics and Gynecology Vaginosis Bacterial Middle Aged Pessaries biology.organism_classification medicine.disease Lactobacillus Urinary Incontinence Vaginal Discharge Vagina Hydroxyquinolines Surgery Female Hormone therapy Bacterial vaginosis business Anaerobic exercise Gels |
| Zdroj: | Female pelvic medicinereconstructive surgery. 24(2) |
| ISSN: | 2154-4212 |
| Popis: | OBJECTIVE The aim of the study was to describe the effect of frequency of pessary removal on the vaginal microenvironment. METHODS We performed a secondary analysis of a multicenter randomized trial of hydroxyquinoline gel in women presenting for pessary fitting. Patients had vaginal secretions analyzed at baseline, 2 weeks, and 3 months. Patients were stratified by frequency of pessary removal at least once daily, at least once weekly, and less often than once weekly. These groups were compared for prevalence of Lactobacillus predominance (primary outcome), anaerobic predominance, Mobiluncus prominence, vaginal symptoms, and bacterial vaginosis by Nugent criteria, and correction for confounding variables was performed. RESULTS One hundred thirty-seven women were included in this analysis: 34 (25%) removed the pessary daily, 54 (39%) at least weekly, and 49 (36%) less often than once weekly. Women who removed the pessary less often than weekly were older (P < 0.01), using more hormone therapy (P = 0.03), and more likely to have bacterial vaginosis at baseline (P < 0.01). At 2 weeks, the predominance of Lactobacillus in the group removing pessary daily was higher (41% daily vs 24% weekly vs 9% longer, P = 0.03) and this persisted after confounder correction (P < 0.01). Women who removed their pessary less than weekly were more likely to have anaerobic predominance at 3 months (P = 0.04). CONCLUSIONS Women who remove their pessaries less often than once weekly have an increased prevalence of anaerobes at 3 months, but no difference in vaginal symptoms or pessary satisfaction. |
| Databáze: | OpenAIRE |
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