How innocent is the vaginal pessary? Two cases of vaginal cancer associated with pessary use

Jain, Ankita; Majoko, Franz; Freites, O.

doi:10.1080/01443610600994825

Cited by 15 publications

(15 citation statements)

References 9 publications

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Section: Discussionmentioning

confidence: 99%

“…52 Although, primary vaginal cancers are uncommon (1%-2% of gynecological malignancies 51 ) Jain and colleagues reported that two vaginal cancers occurred in users of shelf pessaries among 9 cases of vaginal carcinoma reported between 2003 and 2005. 52 Death has resulted from pessary use. An 82-year-old woman with a ring pessary developed vaginal bleeding; biopsies showed extensive surface ulceration, necrosis, and suppurative inflammation, and she died from acute pyelonephritis with hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

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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

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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

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“…Even though the nature of the foreign body was clearly seen and felt, x-ray pelvis was taken in this case to rule out any bony erosion and also for documentation. Complications of a retained pessary include chronic vaginitis, incarceration, ulceration and metaplasia5 and vaginal cancer 6. Other complications include fistula formation, vesicovaginal,7 rectovaginal,8 bowel obstruction,9 urinary tract infections and hydronephrosis 10.…”

Section: Discussionmentioning

confidence: 99%

Incarcerated foreign body in the vagina - a metal bangle used as a pessary

Dasari¹,

Sagili

2012

Case Reports

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Long-forgotten vaginal pessaries get incarcerated in the vagina and their removal poses problems. A 60-year-old postmenopausal woman presented with foul smelling purulent discharge per vaginum and stress incontinence. Speculum examination revealed foul smelling white discharge per vaginum and a friable vaginal wall which bled on touch. The anterior portion of a metal ring deeply embedded in the vagina was seen. The cervix appeared normal. Attempts of removal by traction under local infiltration failed and resulted in bleeding. Biopsy from the tissue covering the ring reported no evidence of malignancy. She was treated with broad-spectrum antibiotics for 1 week and the metallic ring was removed without any complications under general anaesthesia using electrocautery. It was found to be a metallic bangle with design. It is essential to gently cauterise and release the fibrosis over the incarcerated foreign body to achieve safe removal.

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“…Other complications are incarceration, ulceration and metaplasia, urosepsis and hydronephrosis [12]. Jain et al reported two cases of vaginal cancer associated with pessary use [13].…”

Section: Discussionmentioning

confidence: 99%

Bizarre Foreign Objects in the Genital Tract—Our Experience and Review of Literature

Sankhwar¹,

Devyani²,

Pyari³

et al. 2014

OJOG

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Foreign objects in the genital tract are commonly encountered by clinicians in all age groups. Patients may or may not be aware of its presence in the body. Usually presenting as offensive vaginal discharge, rare misplacement of these objects may result in fatal complications. Detailed history and clinical examination are central to diagnosis although imaging modalities may be required in misplaced objects. Proper management can prevent morbidity and mortality resulting from complications. Presented here is a series of three cases where patients presenting with varied complaints were diagnosed with genital foreign bodies and managed.

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How innocent is the vaginal pessary? Two cases of vaginal cancer associated with pessary use

Cited by 15 publications

References 9 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

Incarcerated foreign body in the vagina - a metal bangle used as a pessary

Bizarre Foreign Objects in the Genital Tract—Our Experience and Review of Literature

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