Factors influencing long-term pessary use

Friedman, Sarah T.; Sandhu, Katherine S.; Wang, Cuiling; Mikhail, Magdy S.; Banks, Erika

doi:10.1007/s00192-009-1080-x

Cited by 41 publications

(21 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pessaries have few complications, although some authors suggest that they require lifestyle modification, 13,14 and the variety of shapes and sizes available affords choice and individual fitting. 15 However, data on complications relevant to appropriate discussion of consent with patients and planning of long-term follow up strategies are limited. The side effects of pessary use are not obvious; moreover it is not clear whether the therapeutic impact is high enough to overlook possible risks or which patients benefit the most from pessary treatment.…”

Section: Introductionmentioning

confidence: 99%

An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse

Abdulaziz

Stothers

Lazare³

et al. 2015

CUAJ

View full text Add to dashboard Cite

Introduction: Pessary use is the preferred non-surgical treatment option for female pelvic organ prolapse. As pessaries can be used chronically to alter pelvic floor anatomy, consideration of shortand long-term complications is important in patient management. We systematically reviewed articles describing the complications of pessary use to determine frequency and severity. Methods: A systematic search via MEDLINE and PubMed using the key terms "complications," "pessary," "pelvic organ prolapse," "side effects" was conducted for the years 1952 to 2014 inclusively. Selected articles cited in the publications identified were also considered. Only full-text material published in English was reviewed. All pessary-related complications described were collated; overall frequency within case reports and case series were calculated and severity was graded using the Clavien-Dindo classification. Results: In total, 61 articles met the inclusion criteria. The most common complications reported were vaginal discharge/vaginitis, erosion, and bleeding. Complications were related to pessary shape and material, and duration in situ. Clavien-Dindo classification of complication severity found that all 5 grade levels were attributed to pessary use; serious grade 4 and 5 complications included cancer, adjacent organ fistula and death. Conclusion: There are few detailed reports of complications of pessary use relative to the estimated frequency of pessary use worldwide. Prospective studies documenting complications by shape, material, and size, and objectively classifying complication severity are required. As serious grade 4 and 5 complications of pessary use occur, further development of clinical follow-up guidelines for long-term pessary users is justified.

show abstract

Section: Introductionmentioning

confidence: 99%

An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse

Abdulaziz

Stothers

Lazare³

et al. 2015

CUAJ

View full text Add to dashboard Cite

show abstract

“…It is unfortunate that publication delay may have prevented Friedman et al [1] from citing our recent article [2]. We showed that in six patients with complete uterine prolapse who were fitted with ring pessary, prolapse disappeared even after pessary removal.…”

mentioning

confidence: 73%

“…Longterm follow-up was needed to clarify this phenomenon. The importance of long-term follow-up was also described by Friedman et al [1].…”

mentioning

confidence: 75%

See 1 more Smart Citation

Factors influencing long-term pessary use: comment

Matsubara

2011

Int Urogynecol J

View full text Add to dashboard Cite

“…Pessaries can be successfully fitted in most women [49], with observational studies reporting success in around 50-100 % of cases; however, successful continuation of pessary therapy is much lower, with a reported rate of 14-67% [50][51][52][53][54][55][56][57][58][59]. In addition to prolapse symptoms, stress incontinence has been reported to improve in 23-45 % of cases; studies have also reported improvements for overactive bladder, defecation disorders, sexual function and body image [52,[60][61][62][63].…”

Section: Pessary Therapymentioning

confidence: 99%

Diagnosis and Therapy of Female Pelvic Organ Prolapse. Guideline of the DGGG, SGGG and OEGGG (S2e-Level, AWMF Registry Number 015/006, April 2016)

Baeßler

Aigmüller

Albrich

et al. 2016

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Ziel: Erstellung einer offiziellen, internationalen, interdisziplinären Leitlinie, publiziert und koordiniert von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG). Die Leitlinie wurde für den deutschsprachigen Raum entwickelt und wird neben der DGGG auch von der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe (SGGG) und der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG) mitgetragen. Das Ziel dieser Leitlinie, die von der DGGG publiziert und koordiniert wurde, ist es, durch die Evaluation der relevanten Literatur einen evidenzbasierten Überblick über die Diagnostik sowie konservative und operative Therapie des Descensus genitalis der Frau mit oder ohne Belastungsinkontinenz zu geben. Methoden: Es erfolgte ein systematischer Review sowie Synthese von Daten, anteilig mit Metaanalyse (S2e). Es wurde eine umfassende Literatursuche in MEDLINE, Embase, Cinahl, Pedro und im Cochrane-Register, in Referenzlisten und in den Abstracts der Annual Meetings der International Continence Society und der International Urogynecological Association durchgeführt. Abstracts wurden eingeschlossen, wenn es sich um randomisierte Studien handelte, die als Podiumpräsentation vorgestellt und diskutiert wurden. Es wurden Originalarbeiten seit 2008 eingeschlossen, deren Nachkontrollzeitraum bei mindestens 12 Monaten lag. Für die Beschreibung von perioperativen Komplikationen wurden jegliche Daten herangezogen. Empfehlungen: Es werden Empfehlungen zur Diagnostik, konservativen und operativen Therapie des Genitaldeszensus gegeben, wobei die 3 urogynäkologischen Kompartimente, Prävention oder Behandlung von Belastungsinkontinenz, Vor-und Nachteile von Netzaugmentationen sowie uteruserhaltende Optionen, berücksichtigt

show abstract

Factors influencing long-term pessary use

Abstract: Age greater than 72 years was associated with continued pessary use and history of hysterectomy or prolapse surgery, and stress incontinence were associated with discontinuation.

Cited by 41 publications

References 4 publications

An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse

An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse

Factors influencing long-term pessary use: comment

Diagnosis and Therapy of Female Pelvic Organ Prolapse. Guideline of the DGGG, SGGG and OEGGG (S2e-Level, AWMF Registry Number 015/006, April 2016)

Contact Info

Product

Resources

About