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International Urogynecology Journal

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01-07-2017 | Original Article

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

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

Published in: International Urogynecology Journal | Issue 7/2017

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.

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Title: Pessary types and discontinuation rates in patients with advanced pelvic organ prolapse
Authors: Birte Wolff
Kathryn Williams
Allen Winkler
Lawrence Lind
Dara Shalom
Publication date: 01-07-2017
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 7/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-3228-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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