Factors influencing long-term pessary use

Area of Science:

• Urogynecology
• Pelvic Floor Disorders
• Medical Device Research

Background:

• Pessary devices are commonly used to manage pelvic organ prolapse and urinary incontinence.
• Identifying factors for long-term pessary success is crucial for patient management and treatment adherence.

Purpose of the Study:

• To determine predictors of sustained pessary usage for over one year in women.
• To compare characteristics of women who continued versus discontinued pessary use.

Main Methods:

• Retrospective chart review of 150 women using pessaries for over one year at Montefiore Medical Center.
• Statistical analysis including Chi-square, Fisher's exact test, logistic regression, ROC curves, and Kaplan-Meier survival analysis.

Main Results:

• 23% of women discontinued pessary use within a year.
• Older age at insertion (OR=1.083) and a history of hysterectomy were associated with continued use.
• A history of prolapse repair surgery and stress incontinence were linked to discontinuation.

Conclusions:

• Continued pessary use is associated with patient age over 72 years.
• Previous prolapse surgery and stress urinary incontinence predict pessary discontinuation.
• These findings can inform patient selection and counseling for pessary therapy.