Massive vesico-vaginal fistula caused by a shelf pessary

Popli, Kiran; Ranka, Prakash; Mustafa, Fuad

doi:10.1080/01443610701577370

Cited by 6 publications

(1 citation statement)

References 6 publications

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“…Thirteen papers discussed complications related to pessary size. [20][21][22][23][24][25][26][27][28][29][30][31] By combining the data in both case reports and case studies, we found that the most frequent complications were: vaginal discharge, bleeding, vesicovaginal fistula, erosion, ulceration, and foul odor (Table 1). We graded the reported complications using the Clavien-Dindo classification (Table 3).…”

Section: Resultsmentioning

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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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: Resultsmentioning

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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Lesiones vaginales por pesario. Estudio de casos y revisión de la literatura

López-Olmos¹

2013

Clínica e Investigación en Ginecología y Obstetricia

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Evaluation of vaginal pessary management: A UK-based survey

Gorti

Hudelist

Simons

2009

Journal of Obstetrics and Gynaecology

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The use of intravaginal pessaries has been proven integral in the conservative treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). Although there is no shortage of studies supporting the efficacy of intravaginal devices for conservative management of POP and UI and a large variety of pessaries are widely used in the UK, data on the clinical practice and recommended changing intervals are lacking. To evaluate the current clinical practice and management of patients with vaginal pessaries, self-administered questionnaires were mailed to all UK-based consultant obstetricians and gynaecologists. A total of 640 out of 1,173 (54.6%) clinicians approached returned the questionnaire, out of which 555 (86.7%) used vaginal pessaries. A total of 129 out of 555 (23.3%) clinicians claimed to change their patients pessaries every 3-6 months; 372 (67.0%) every 6 months and 54 (9.7%) reported a frequency of 6-12 months before changing the device. Complication rates of 40.3%, 35.2% and 18.5% were observed by clinicians performing 3-6 monthly, 6-monthly and up to 12-monthly changing intervals. Discontinuation of pessary use was related to recurrent involuntary expulsion in 54.0% (268/496), discomfort (27.4%, 136/49), vaginal bleeding and infection (7.8%, 39/496 clinicians) and dislike of the changing procedure (10.7%, 53/496). Changing intervals greatly vary between clinicians all over the country. The lack of differences in proportions of complications observed in 3-monthly and even up to 12-monthly observation periods suggest that 6-monthly and probably up to 12-monthly intervals represent a safe and cost-effective regimen to follow-up patients with vaginal pessaries.

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Massive vesico-vaginal fistula caused by a shelf pessary

Cited by 6 publications

References 6 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

Lesiones vaginales por pesario. Estudio de casos y revisión de la literatura

Evaluation of vaginal pessary management: A UK-based survey

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