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Pessary Management Approach Affects Likelihood of Surgery.

Yufan Brandon Chen, Christian Lowe1, Amy Wozniak2

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Summary
This summary is machine-generated.

Pessary self-management for pelvic organ prolapse and urinary incontinence is linked to fewer surgeries than office management. Factors like age and BMI influence management type.

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Area of Science:

  • Urogynecology
  • Pelvic Floor Disorders
  • Surgical Management

Background:

  • Pessary use is common for pelvic organ prolapse (POP) and stress urinary incontinence (SUI).
  • The impact of pessary management type (self- vs. office-managed) on surgical intervention rates remains unclear.

Purpose of the Study:

  • To compare surgical treatment rates for POP or SUI based on pessary management type.
  • To identify patient factors associated with different pessary management strategies.

Main Methods:

  • Retrospective cohort study of 218 first-time pessary users (2012-2014).
  • Primary outcome: Likelihood of surgery using multivariable Cox proportional hazards models.
  • Secondary outcomes: Patient factors associated with management type via multivariable logistic regression.

Main Results:

  • Self-management (72.9%) was more common than office management (27.1%).
  • Surgical rates were lower in self-managed patients (19.3%) compared to office-managed patients (35.1%).
  • Increased age, BMI, and genital hiatus were associated with higher odds of office management.

Conclusions:

  • Pessary self-management is associated with reduced surgical intervention rates for POP and SUI compared to office management.
  • Age, BMI, and genital hiatus are key factors influencing the choice between self- and office-based pessary management.