Pessaries (mechanical devices) for managing pelvic organ prolapse in women

Bugge, Carol; Adams, Elisabeth J; Gopinath, Deepa; Stewart, Fiona; Dembinsky, Melanie; Sobiesuo, Pauline; Kearney, Rohna

doi:10.1002/14651858.cd004010.pub4

Cited by 49 publications

(66 citation statements)

References 71 publications

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“…In our case the patient had the history of using pessary for around 10 years before she came to our hospital. Despite the pessary, that placed into the vagina to restore pelvic anatomy and decrease prolapse symptoms, is the only available, nonsurgical rst-line intervention especially for high-risk surgical candidates with POP that can relieve prolapse and urinary symptoms, it can cause serious complications such as bleeding and ulceration [5] that our index patient also appeared. Although the pessary itself does not cause cervical cancer, but the underlying increasing chance of nonspeci c infection that above-mentioned with the repeated take out and put in of the pessary may be one considerable factor for the progression of disease, so that the cervical carcinogenesis and precancerous changes of the vagina that con rmed through postoperative pathological analysis.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Radical Hysterectomy and Tension-Free Vaginal Tape-Obturator (TVT-O) Combined to Treat Cervical Cancer Complicating Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI): A Case Report

Ran

Liu

et al. 2021

Preprint

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Background: Combined cervical cancer and pelvic organ prolapse (POP) is extremely uncommon and there is no standard treatment guideline for the complex comorbidity. We attempted to provide a treatment strategy and explore possible reasons for the comorbidities.Case presentation: We presented a 62-year-old patient seeking treatment for postmenopausal tissue prolapse and leakage of urine, physical examination revealed procidentia with a 2.5 cm papillary and erosive lesion that was pathologically confirmed as cervical squamous cell carcinoma in stage Ib2. Clinical diagnosis included cervical squamous cell carcinoma in stage Ib2, prolapse of the anterior and posterior walls of the vagina and uterine, stress urinary incontinence (SUI), and then she was performed radical surgery for cervical cancer and tension-free vaginal tape-obturator (TVT-O), the urine function was good after operation. The surgery solved two diseases at the same time that improve the QOL of patients while radically curing cervical malignancies.Conclusions: Surgical-based treatment seems to be more suitable that can cure the two diseases and improve the QOL. We should pay attention to the potential high incidence of HPV infection and HPV-related cervical cancer so that don't ignore the screening for cervical cancer in the prolapse group and initiate surgery treatment strategies of cervical cancer or pre-cancerous lesions as early soon as possible to reach an optimal outcome of patient.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Radical Hysterectomy and Tension-Free Vaginal Tape-Obturator (TVT-O) Combined to Treat Cervical Cancer Complicating Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI): A Case Report

Ran

Liu

et al. 2021

Preprint

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Section: Introductionmentioning

confidence: 99%

“…Pelvic organ prolapse (POP) is a common condition affecting mostly postmenopausal women, with a peak age prevalence at 60–69 years [ 1 , 2 ]. The symptoms significantly impair women’s daily activities and quality of life [ 1 , 3 ]. POP involves the descent of one or more perineal organs (uterus, bladder, and/or rectum) from the normal anatomic position into the vagina [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

Torres-Lacomba

Navarro-Brazález

Yuste-Sánchez

et al. 2022

JPM

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In this study, we aimed to investigate women’s experiences with compliance with prescribed pelvic floor muscle exercises (PFMEs) and lifestyle changes 6–12 months after completing an individual pelvic floor physiotherapy program. This study was targeted to understanding factors affecting adherence to PFMEs and lifestyle changes to deal with pelvic organ prolapse (POP) symptoms. We designed this research as a descriptive qualitative study. We conducted this study from December 2016 to September 2017 in Madrid, Spain. Twenty-six women with symptomatic POP selected using a purposive sampling method participated in six focus groups and three one-to-one semi-structured interviews. Three authors coded and inductively analyzed transcript contents with iterative theme development. A thematic analysis revealed three main themes: (1) symptoms change; (2) PFMEs and lifestyle changes performance; and (3) a health practitioner–patient relationship. Women identified as adherent reported improvement in physical symptoms and emotional and general state as a result of the new knowledge achieved. Fear also promoted compliance with performing PFMEs and adopting lifestyle changes. Likewise, PFMEs preference and routine, integration of PFMEs and lifestyle changes into activities of daily living, support guides, therapeutic alliance, individual supervision, follow-up, and feedback were also identified as adherence facilitators. One of the biggest barriers that we identified was responsibility. Compliance with prescribed PFMEs and lifestyle changes can be improved with effective individual, women-centered, and supervised physiotherapy programs reducing symptoms, including exercises aligned with women’s preferences that are easy to integrate in daily living, promoting knowledge and awareness of their condition, providing written or electronic guidelines, with routine follow-up visits offering both positive feedback and clear and consistent messages, and enhancing therapeutic alliance.

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“…Taken PFMT for instance, although previous randomised controlled trials (RCTs) reported that patients in PFTM group reported significantly more improvement on POP symptoms than that in control group, the clinical importance of the differences observed and its long-term effect remain suspicious 9–11. Other factors, such as constrains on indications, incidence of complications and recurrence of POP symptoms, often limit the acceptance and application of these non-surgical treatment to a wider population 3 8 12 13…”

Section: Introductionmentioning

confidence: 99%

Effect of electroacupuncture on symptoms of female pelvic organ prolapse (stage II–III) (EAPOP study): protocol of a randomised controlled trial

et al. 2022

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IntroductionPelvic organ prolapse (POP) is downward descent of pelvic organs, which causes symptoms of the lower genital, urinary and gastrointestinal tracts, and undermines women’s daily activities and quality of life. Although studies indicated that electroacupuncture (EA) may be effective in improving the POP symptoms, evidences were not robust. Therefore, this study aims to conduct a randomised controlled trial (RCT) to evaluate the efficacy and safety of electroacupuncture on relieving symptoms of a POP stage II and III among women.Methods and analysisA two-arm, multicentre, patient-blind RCT will be conducted to compare EA with sham electroacupuncture (SEA) for treating symptoms of POP stage II and III among women in six tertiary hospitals in China. One hundred and sixty eligible women will be assigned with a 1:1 ratio to have received either EA or SEA for 24 times in 12 weeks and followed-up for 24 weeks. The primary outcome will be the change on the total score of the Pelvic Floor Distress Inventory-short form 20 at week 12 from baseline, and will be analysed by t-test or multiple regression model. Intention-to-treat analysis will be performed for all outcomes, and a p value of less than 0.05 (two-sided testing) will be considered as statistical significance.Ethics and disseminationThe study protocol has been approved by the Medical Ethical Committee of Guang’ammen Hospital (No. 2019-249-KY-01). Patients will be informed about the details of the study and asked to sign consent form before enrolment. The results of this study are expected to be written and published on peer-reviewed journals.Trial registration numberNCT04589715.

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Pessaries (mechanical devices) for managing pelvic organ prolapse in women

Abstract: www.cochranelibrary.comPessaries (mechanical devices) for managing pelvic organ prolapse in women (Review)

Cited by 49 publications

References 71 publications

Laparoscopic Radical Hysterectomy and Tension-Free Vaginal Tape-Obturator (TVT-O) Combined to Treat Cervical Cancer Complicating Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI): A Case Report

Laparoscopic Radical Hysterectomy and Tension-Free Vaginal Tape-Obturator (TVT-O) Combined to Treat Cervical Cancer Complicating Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI): A Case Report

Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

Effect of electroacupuncture on symptoms of female pelvic organ prolapse (stage II–III) (EAPOP study): protocol of a randomised controlled trial

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