PESSARY USE IN PELVIC ORGAN PROLAPSEIN WOMEN
M. MONROY1, M. URZUA1, J. ALVAREZ 2, C. RONDINI 1;
1Hosp. Padre Hurtado, Santiago, Chile, 2Urogyneccologydepartment, Hosp. Padre Hurtado, Santiago, Chile.
Introduction: Pelvic organprolapse is a common condition. Apart from surgical options, it canbe treated conservatively with PFMT and pessaries. Although the useof pessaries is common worldwide, there is no consensus about the useof different types of devices, the indications, the pattern ofmaintenance or replacement, and follow-up care
Objective:The objective is to describe our experience of vaginal pessaries as aconservative treatment for women with pelvic organprolapses.
Methods: A prospective study was carried outbetween January 2015 and January 2017, in which 62 women with pelvicorgan prolapse had a pessary trial at the urogynecology unit in ourinstitution. Patients received information about pessary use andmaintenance. A follow-up appointment was scheduled one week later,and then every 3 month for the next evaluations, or before aspatients required Data collection included: demographics, POPinformation, pessary outcomes, and complications.specific informationconcerning pessary use.
Results: Forty six patients, meanage 71 years (63-89) were included, , Parity mean 4 children (0-12).BMI mean 29.3. 16 abort treatment, 3 rejected treatment or secondcontrol and 13/46 did not get a correct fitting Histerectomy 2/13 onno pessary group and 1/46 on pessary group. Complete POP (procidence)37% (17/46), anterior and/or posterior prolapse 57% (26/46),completePOP 3/46. Fitting test mean was 2 times. Pessary types 27/46 ring,6/46 donut, 8/46 cube and 5/46 gelhorn Follow-up mean was 18 months(1-24 meses). self implanted in 5/46 (11%). A 57% (26/46) was betterin PGI-I questionary, so 59% (27%46) recommended its use.Nevertheless a 46% (21/46) continued using on a regular basis.Complications were reported as ulcers in 20% (9/46) and leucorrea in46% (21/46).
Conclusions: In our experience, pessary is aneffective and safe alternative treatment for women with symptomaticpelvic organ prolapse.