Predictors for long-term adherence to vaginal pessary in pelvic organ prolapse: a prospective study

Niigaki, Danielle I; Silva, Rebecca S. P.; Bortolini, Maria Augusta Tezelli; Fitz, Fátima Faní; Castro, Rodrigo Aquino

doi:10.1007/s00192-022-05133-5

Cited by 7 publications

(1 citation statement)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Age as a risk factor for long-term discontinuation remains uncertain. Some studies reported that older women are more likely to continue vaginal pessary [7,8,[17][18][19]. However, women who are older than 70 years had a signi cantly higher discontinuation rates in our study.…”

Section: Discussioncontrasting

confidence: 68%

Long-term continuations rate of ring pessary use for symptomatic pelvic organ prolapse

Manchana

2024

Arch Gynecol Obstet

View full text Add to dashboard Cite

To evaluate long-term continuation rates, adverse events of ring pessary use at a minimum of 5 years follow-up, and factors associated with discontinuation in symptomatic pelvic organ prolapse (POP) MethodsWomen with symptomatic POP who were treated with vaginal ring pessary and had successful ttings were included. Adverse events and reasons for discontinuation of pessary use were recorded. Patients who were lost to follow-up were de ned as discontinued. ResultsDuring 12 year-period, 239 of 329 POP patients(72.6%) had successful ttings with ring pessary. The mean age was 67.8 ± 8.9 years(range 27-86) and 70% of patients had advanced stage. The cumulative probability of continued ring pessary use was 84.1%,64.4%,49.3%,and 33.5%, at 1,3,5,and 10 years, respectively. Most common reason for discontinuation was frequent expulsion(21.6%), followed by vaginal erosion(16.5%), no prolapse improvement(12.4%), and inability or inconvenience to do selfcare(9.3%). However, 9 patients(9.3%) had improvement of prolapse and were able to discontinue pessary insertion. Age above 70 years, wide genital hiatus, and incapability of self-care are independent factors associated with long-term discontinuation. Adverse events occurred in 23.4% of patients,18.8% of them had vaginal erosion,11.7% vaginal discharge/infection, and 18.4% de novo SUI. However, no statistical signi cance existed between those who continued and discontinued pessary use due to these adverse events. ConclusionRing pessary is an effective treatment in symptomatic POP, with acceptable long-term continuation rates and minor adverse events. Self-care of pessary is very important aiming to minimize adverse events.Advanced age, wide introitus and incapability of self-care were associated factors for long-term discontinuation.A take-home message Ring pessary is an effective treatment in women with symptomatic POP. It has acceptable long-term continuation rate and minor adverse events.

show abstract

Section: Discussioncontrasting

confidence: 68%