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Predictors for long-term adherence to vaginal pessary in pelvic organ prolapse: a prospective study.
Int Urogynecol J. 2022 Mar 14 [Online ahead of print]IU

Abstract

INTRODUCTION AND HYPOTHESIS

The objective was to investigate the rate of adherence to pessary treatment for pelvic organ prolapse (POP), to identify factors associated with long-term (longer than 1 year) use of vaginal pessaries in Brazilian women with POP and its impact on quality of life (QoL).

METHODS

A prospective observational study assessed 247 consecutive women candidates for a pessary to manage symptomatic POP. Patients were fitted with a ring pessary and follow-up visits were performed at 1, 6, and 12 months. Pessary complications and reasons for discontinuation were recorded. Prolapse Quality of Life Questionnaire (P-QoL) was applied at baseline and after 1 year of treatment. We used a logistic regression model for the analyses, with p < 0.05 for significance.

RESULTS

A total of 236 women were included in the study, of whom 110 (46.6%) maintained the pessary treatment for longer than 12 months. The main reason for pessary discontinuation was the patient opting for surgery (50.8%). Vulvovaginitis was the main long-term complication (44.5%), followed by vaginal ulceration (16.4%) and urinary urgency (10%). No prior hysterectomy (OR = 2.26; 95% CI 1.19-4.31), vaginal estrogen use (OR = 1.94; 95% CI 1.06-3.52), and mean age (OR = 1.03; 95% CI 1.01-1.06) were variables associated with long-term use of vaginal pessary (p < 0.05 for all). Total P-QoL score significantly changed with pessary use (519.1 at baseline and 260 after 12-month treatment, p < 0.00).

CONCLUSIONS

Our study suggests that no prior hysterectomy, the local estrogen therapy, and age might be factors associated with use of a ring vaginal pessary for longer than 1 year. Long-term pessary users had a significant improvement in their quality of life.

Authors+Show Affiliations

Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros, 608-Vila Clementino, São Paulo, SP, CEP: 04024-002, Brazil.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros, 608-Vila Clementino, São Paulo, SP, CEP: 04024-002, Brazil.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros, 608-Vila Clementino, São Paulo, SP, CEP: 04024-002, Brazil. maria.augusta@gmail.com.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros, 608-Vila Clementino, São Paulo, SP, CEP: 04024-002, Brazil.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros, 608-Vila Clementino, São Paulo, SP, CEP: 04024-002, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35286427

Citation

Niigaki, Danielle I., et al. "Predictors for Long-term Adherence to Vaginal Pessary in Pelvic Organ Prolapse: a Prospective Study." International Urogynecology Journal, 2022.
Niigaki DI, Silva RSP, Bortolini MAT, et al. Predictors for long-term adherence to vaginal pessary in pelvic organ prolapse: a prospective study. Int Urogynecol J. 2022.
Niigaki, D. I., Silva, R. S. P., Bortolini, M. A. T., Fitz, F. F., & Castro, R. A. (2022). Predictors for long-term adherence to vaginal pessary in pelvic organ prolapse: a prospective study. International Urogynecology Journal. https://doi.org/10.1007/s00192-022-05133-5
Niigaki DI, et al. Predictors for Long-term Adherence to Vaginal Pessary in Pelvic Organ Prolapse: a Prospective Study. Int Urogynecol J. 2022 Mar 14; PubMed PMID: 35286427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors for long-term adherence to vaginal pessary in pelvic organ prolapse: a prospective study. AU - Niigaki,Danielle I, AU - Silva,Rebecca S P, AU - Bortolini,Maria Augusta Tezelli, AU - Fitz,Fátima F, AU - Castro,Rodrigo A, Y1 - 2022/03/14/ PY - 2021/11/07/received PY - 2022/02/07/accepted PY - 2022/3/14/entrez PY - 2022/3/15/pubmed PY - 2022/3/15/medline KW - Adherence KW - Long-term KW - Pelvic organ prolapse KW - Pessary KW - Predictor KW - Ring pessary JF - International urogynecology journal JO - Int Urogynecol J N2 - INTRODUCTION AND HYPOTHESIS: The objective was to investigate the rate of adherence to pessary treatment for pelvic organ prolapse (POP), to identify factors associated with long-term (longer than 1 year) use of vaginal pessaries in Brazilian women with POP and its impact on quality of life (QoL). METHODS: A prospective observational study assessed 247 consecutive women candidates for a pessary to manage symptomatic POP. Patients were fitted with a ring pessary and follow-up visits were performed at 1, 6, and 12 months. Pessary complications and reasons for discontinuation were recorded. Prolapse Quality of Life Questionnaire (P-QoL) was applied at baseline and after 1 year of treatment. We used a logistic regression model for the analyses, with p < 0.05 for significance. RESULTS: A total of 236 women were included in the study, of whom 110 (46.6%) maintained the pessary treatment for longer than 12 months. The main reason for pessary discontinuation was the patient opting for surgery (50.8%). Vulvovaginitis was the main long-term complication (44.5%), followed by vaginal ulceration (16.4%) and urinary urgency (10%). No prior hysterectomy (OR = 2.26; 95% CI 1.19-4.31), vaginal estrogen use (OR = 1.94; 95% CI 1.06-3.52), and mean age (OR = 1.03; 95% CI 1.01-1.06) were variables associated with long-term use of vaginal pessary (p < 0.05 for all). Total P-QoL score significantly changed with pessary use (519.1 at baseline and 260 after 12-month treatment, p < 0.00). CONCLUSIONS: Our study suggests that no prior hysterectomy, the local estrogen therapy, and age might be factors associated with use of a ring vaginal pessary for longer than 1 year. Long-term pessary users had a significant improvement in their quality of life. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/35286427/Predictors_for_long_term_adherence_to_vaginal_pessary_in_pelvic_organ_prolapse:_a_prospective_study_ L2 - https://dx.doi.org/10.1007/s00192-022-05133-5 DB - PRIME DP - Unbound Medicine ER -
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