Three-dimensional printing vaginal pessary to treat pelvic organ prolapse: A pilot study

Abstract

Objective Pelvic organ prolapse (POP) is a common gynecological condition and pessaries are offered as a first line management, however, each woman presents with unique anatomy and thus the effectiveness of commercially available pessaries may be limited by lack of customization. This study aims to apply three-dimensional (3D) printing technology in seeking resolution. Design, setting, population and methods This was a pilot study, 6 patients with mean age 68 years (57 to 74) were treated with Gellhorn pessary for symptomatic POP were enrolled in our study. We put the Gellhorn-type pessary into the vagina to restore the prolapsed parts and under transvaginal ultrasound (US) guided to evaluate the gap which Gellhorn pessary can’t cover. Ototoform (an impression silicone) was used to make a sphere-shape mode and have it hooked onto Gellhorn pessary (template). We collected template and then applied 3D printing to customize silicone vaginal pessary. Results All 6 patients were satisfied with the customized made pessaries. No patients complained of adverse effects, such as discomfort, expulsion of the pessary, urinary incontinence, difficulty in urination or bowel movement, and vaginal bleeding during the study. Conclusions Our study demonstrates that a tailor made pessary may offer better solution for women with POP. A customized pessary can be made with the help of transvaginal US and 3D printing technology. Any local clinic can use simple tools (i.e. transvaginal US and pessary) with assistance from a 3D printing center to create a well fit pessary. With our innovation, distant is not a boundary.