Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life

Abstract

Stress urinary incontinnce (SUI) is a common condition among women. The usual approach to treatment of SUI is a stepwise plan from conservative to surgical procedures. A vaginal pessary is one of the commonly used conservative treatments that offer symptomatic improvement for women with incontinence. This review provides a critical analysis of the benefits and shortcomings offered by vaginal pessaries to patients affected by SUI, with a particular focus on indications, advantages, quality of life, patient satisfaction, and potential complications. To obtain the required information, an extensive search of PubMed and Cochrane databases was performed, covering the time frame from January 2000 to December 2016. We also surveyed the published guidelines of American Urological Association, Canadian Urological Association, American Urogynecological Society, National Institutes of Health (USA), and National Institute for Health and Care Excellence (UK). A total of 192 original research papers, review articles, and clinical trials were identified. The analysis of retrieved data provides evidence that vaginal pessaries constitute an effective nonsurgical option for SUI. The satisfaction rate with pessary use is high and only minor complications, if any, occur, vaginal discharge being the most common. The reviewed studies document that vaginal pessaries provide an adequate control of SUI if they are fit properly and managed by frequent replacements and regular checkups. They should be considered among the first line of treatment for SUI associated with exercise and increased intra-abdominal pressure.

The Effect of Pelvic Floor Muscle Strengthening Exercise on Urinary Incontinence and Quality of Life in Patients after Prostatectomy: a Randomized Clinical Trial

“…5,6 Many studies have been conducted on the effectiveness of pelvic floor muscle exercises in reducing the degree of the severity of urinary incontinence in women in their reproductive ages, in their postpartum period, with stress incontinence and also the elderly. 21,[25][26][27] Lucio et al, studied the effect of pelvic floor muscle exercise training on symptoms of the lower urinary tract dysfunction and quality of life in women with multiple sclerosis. 28,29 However, despite the high prevalence of postprostatectomy urinary incontinence, very few studies have been conducted on the effect of these exercises on urinary incontinence and quality of life in such patients.…”

Non-Hormonal Contraceptive Device with Multiple Uses: Increases The Effectiveness of Fertility Awareness Methods and Controls Stress Incontinence

“…The ring pessary is most widely used however, more pessaries of different shapes and sizes (Figure 14, 16) have been introduced into the market with the hope of achieving better results. Currently available pessaries have significant limitations such as displacement, erosion or even ulceration and urethral obstruction [16,17,18,19]. The FemCap shows marked similarity to the ring pessary.…”

Multidisciplinary management of women with pelvic organ prolapse, urinary incontinence and lower urinary tract symptoms. A clinical and psychological overview

“…Vaginal pessaries are an effective conservative treatment characterized by a rather low complications rate and high level of satisfaction of women treated with this device [96].…”