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A simplified protocol for pessary management

V Wu¹, S A Farrell, T F Baskett

¹Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.

Obstetrics and Gynecology

|December 16, 1997

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A simplified pessary management protocol is effective for pelvic organ prolapse. This approach allows for safe, long-term pessary use, reducing the need for frequent pelvic examinations.

Area of Science:

Urogynecology
Pelvic Floor Disorders

Background:

Pelvic organ prolapse (POP) affects many women.
Pessary management is a common treatment option for POP.
Current management protocols can be intensive.

Purpose of the Study:

To evaluate a simplified protocol for pessary management in women with symptomatic pelvic organ prolapse.
To determine the safety and efficacy of a less frequent follow-up schedule.

Main Methods:

Prospective study of women with POP opting for pessary management.
Initial pessary fitting followed by re-examinations at 2 weeks, then 3- to 6-month intervals.
Life-table analysis to assess long-term usage.

Main Results:

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74% of 110 women were successfully fitted with a pessary.

66% and 53% of users remained on pessaries after 12 and 36 months, respectively.

No serious complications were noted; stress incontinence and complete vaginal eversion were associated with lower success rates.

Conclusions:

Simplified pessary management protocols are safe and effective.
Frequent pelvic examinations during pessary use can be safely reduced.
Pessaries are a viable long-term treatment for pelvic organ prolapse.