Preexisting stress urinary incontinence: a predictor of discontinuation with pessary management

To identify variables predictive of pessary discontinuation in the treatment of pelvic organ prolapse.

Forty-two women with symptomatic pelvic organ prolapse presenting at a hospital-based urogynecology practice without a prior history of pessary use who opted for this form of management were included in the study. Data collected included vaginal paritye, presence or absence of symptomatic urinary incontinence, and previous pelvic surgery.

Of the 42 patients, 24 (57%) were successfully managed with a pessary while 18 (43%) discontinued pessary use and were categorized as failures. Patients with preexisting urinary incontinence were more likely to discontinue pessary usage (OR 10.2 [1.06-240.96]). Logistic regression analysis indicated that stress urinary incontinence was the only significant type of incontinence predictive of discontinuation of pessary usage (p = .04).

Preexisting stress urinary incontinence may be an independent predictor of pessary failure in the management of pelvic organ prolapse.