Effect of Pessary Use on Genital Hiatus Measurements in Women With Pelvic Organ Prolapse

Abstract

After 3 months of pessary use, genital hiatus size decreased significantly. Pessary use results in significant anatomic changes to the genital hiatus in patients with pelvic organ prolapse.

Quality of Life Questionnaires for the Assessment of Pelvic Organ Prolapse: Use in Clinical Practice

“…Responses to QOL questionnaires have revealed that patient satisfaction with medium‐term pessary use is high (70–92%) and is also associated with increased frequency and satisfaction with sexual activity, underscoring the fact that sexual activity should not be considered a contraindication to pessary use. Improvement in both bulge and irritative bladder symptoms are the most consistent findings across most studies evaluating the effect of pessary use on QOL, though two studies reported new onset of UI . In a prospective observational cohort study, Komesu et al found that while pessary use improved both bladder and prolapse symptoms, they were more effective in improving symptoms of prolapse .…”

Quality of Life Questionnaires for the Assessment of Pelvic Organ Prolapse: Use in Clinical Practice

“…Responses to QOL questionnaires have revealed that patient satisfaction with medium‐term pessary use is high (70–92%) and is also associated with increased frequency and satisfaction with sexual activity, underscoring the fact that sexual activity should not be considered a contraindication to pessary use. Improvement in both bulge and irritative bladder symptoms are the most consistent findings across most studies evaluating the effect of pessary use on QOL, though two studies reported new onset of UI . In a prospective observational cohort study, Komesu et al found that while pessary use improved both bladder and prolapse symptoms, they were more effective in improving symptoms of prolapse .…”

Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

“…They further suggested that continued pessary use may result in some degree of recovery in the levator ani. 16 Based on transperineal ultrasound images of the levator hiatal area, Manzini et al reported that 3 months of pessary use was associated with changes in the puborectalis muscle (PRM) function of women with POP. They further proposed that vaginal pessaries might reduce the need for continuous contraction to support POP, which would allow the PRM to relax.…”

“…Jones et al demonstrated a significant decrease in the genital hiatus size of 42 patients with POP after 3 months of pessary use. They further suggested that continued pessary use may result in some degree of recovery in the levator ani 16 . Based on transperineal ultrasound images of the levator hiatal area, Manzini et al reported that 3 months of pessary use was associated with changes in the puborectalis muscle (PRM) function of women with POP.…”

Comparison of the Perineal Body Between Chinese Women With Pelvic Organ Prolapse and Women With Normal Support by Magnetic Resonance Imaging With 3-Dimensional Reconstruction

“…Multiple studies have suggested that gh enlargement may be associated with prolapse recurrence 15–18 . Historically, procedures intended to reduce the gh have been targeted at repairing level 3 support 19,20 . Therefore, perineorrhaphy and posterior repair are still currently being performed.…”

Quality of Life Questionnaires for the Assessment of Pelvic Organ Prolapse: Use in Clinical Practice

“…Responses to QOL questionnaires have revealed that patient satisfaction with medium‐term pessary use is high (70–92%) and is also associated with increased frequency and satisfaction with sexual activity, underscoring the fact that sexual activity should not be considered a contraindication to pessary use. Improvement in both bulge and irritative bladder symptoms are the most consistent findings across most studies evaluating the effect of pessary use on QOL, though two studies reported new onset of UI . In a prospective observational cohort study, Komesu et al found that while pessary use improved both bladder and prolapse symptoms, they were more effective in improving symptoms of prolapse .…”

Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

“…They further suggested that continued pessary use may result in some degree of recovery in the levator ani. 16 Based on transperineal ultrasound images of the levator hiatal area, Manzini et al reported that 3 months of pessary use was associated with changes in the puborectalis muscle (PRM) function of women with POP. They further proposed that vaginal pessaries might reduce the need for continuous contraction to support POP, which would allow the PRM to relax.…”

“…Jones et al demonstrated a significant decrease in the genital hiatus size of 42 patients with POP after 3 months of pessary use. They further suggested that continued pessary use may result in some degree of recovery in the levator ani 16 . Based on transperineal ultrasound images of the levator hiatal area, Manzini et al reported that 3 months of pessary use was associated with changes in the puborectalis muscle (PRM) function of women with POP.…”

Comparison of the Perineal Body Between Chinese Women With Pelvic Organ Prolapse and Women With Normal Support by Magnetic Resonance Imaging With 3-Dimensional Reconstruction

“…Multiple studies have suggested that gh enlargement may be associated with prolapse recurrence 15–18 . Historically, procedures intended to reduce the gh have been targeted at repairing level 3 support 19,20 . Therefore, perineorrhaphy and posterior repair are still currently being performed.…”

Quality of Life Questionnaires for the Assessment of Pelvic Organ Prolapse: Use in Clinical Practice

“…Responses to QOL questionnaires have revealed that patient satisfaction with medium‐term pessary use is high (70–92%) and is also associated with increased frequency and satisfaction with sexual activity, underscoring the fact that sexual activity should not be considered a contraindication to pessary use. Improvement in both bulge and irritative bladder symptoms are the most consistent findings across most studies evaluating the effect of pessary use on QOL, though two studies reported new onset of UI . In a prospective observational cohort study, Komesu et al found that while pessary use improved both bladder and prolapse symptoms, they were more effective in improving symptoms of prolapse .…”

Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

“…They further suggested that continued pessary use may result in some degree of recovery in the levator ani. 16 Based on transperineal ultrasound images of the levator hiatal area, Manzini et al reported that 3 months of pessary use was associated with changes in the puborectalis muscle (PRM) function of women with POP. They further proposed that vaginal pessaries might reduce the need for continuous contraction to support POP, which would allow the PRM to relax.…”

“…Jones et al demonstrated a significant decrease in the genital hiatus size of 42 patients with POP after 3 months of pessary use. They further suggested that continued pessary use may result in some degree of recovery in the levator ani 16 . Based on transperineal ultrasound images of the levator hiatal area, Manzini et al reported that 3 months of pessary use was associated with changes in the puborectalis muscle (PRM) function of women with POP.…”

Comparison of the Perineal Body Between Chinese Women With Pelvic Organ Prolapse and Women With Normal Support by Magnetic Resonance Imaging With 3-Dimensional Reconstruction

“…Multiple studies have suggested that gh enlargement may be associated with prolapse recurrence 15–18 . Historically, procedures intended to reduce the gh have been targeted at repairing level 3 support 19,20 . Therefore, perineorrhaphy and posterior repair are still currently being performed.…”