Pessary types and discontinuation rates in patients with advanced pelvic organ prolapse

Birte Wolff, Kathryn Williams, Allen Winkler, Lawrence Lind, Dara Shalom

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Introduction and hypothesis: The aim of this study was to investigate factors associated with long-term pessary use in patients with advanced pelvic organ prolapse (POP). Methods: This was a retrospective chart review of patients with POP of stage ≥2 managed with a pessary. Patients were excluded if the date of fitting or follow-up was unavailable. Long-term use was defined as more than 1 year. Patient demographics, pessary fitting, and follow-up visit dates were collected. The primary end point was the duration of use and the prognostic impact of pessary type. Secondary objectives addressed other influencing factors including age, estrogen use, and prolapse stage. The data were analyzed using SPSS version 21. Results: The final analysis included 311 patients. The mean (± standard deviation, SD) duration of pessary use was 7.0 ± 0.72 years (median 5.7 years). Long-term use was found in 76 % (164) of these patients. Factors associated with longer use were age >65 years (p = 0.004) and estrogen use (p = 0.048). The estimated mean (± SD) durations of use of the Gellhorn, open ring, ring with support, cube and donut pessaries were 10.5 ± 0.7 years, 3.4 ± 0.6 years, 1.8 ± 0.2 years, 1.8 ± 0.3 years and 1.7 ± 0.5 years, respectively. The Gellhorn pessary was associated with significantly longer use than other pessary types (10.5 ± 0.7, p < 0.0000001); this finding was independent of age, prolapse stage, hysterectomy, and vaginal estrogen use. Conclusions: In this retrospective analysis, the duration of use was longest with the Gellhorn pessary. Older age and vaginal estrogen use were associated with longer pessary use.

Original languageEnglish (US)
Pages (from-to)993-997
Number of pages5
JournalInternational Urogynecology Journal
Volume28
Issue number7
DOIs
StatePublished - Jul 1 2017

Keywords

  • Estrogen
  • Gellhorn pessary
  • Pelvic organ prolapse
  • Pessary

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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