Urinary incontinence secondary to a vaginal pessary

Chow, Shih-Han; LaSalle, Michael D.; Rosenberg, Gene S.

doi:10.1016/s0090-4295(96)00453-0

Cited by 10 publications

(2 citation statements)

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“…Vesicovaginal fistulas (VVFs), although uncommon, are among the most serious complications of neglected pessaries. 48 The reports identify Gellhorn and shelf designs most often; 12 rectovaginal fistula and VVFs appear more common with rubber or PVC pessaries when compared with polythene pessaries. 35 Fistula formation may also be associated with fecal impaction, hydronephrosis, and urosepsis, 32 however, these complications were generally reported in the setting of neglect.…”

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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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%

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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“…VVFs and RVFs, although uncommon, are among the most serious complications of neglected pessaries [63]. They are defined as abnormal communication of the vaginal epithelium with the bladder epithelium or with the wall of the rectum, respectively.…”

Section: Discussionmentioning

confidence: 99%

Complications of Pessaries Amenable to Surgical Correction: Two Case Reports and a Systematic Review of the Literature

Sastre

Pérez-Cejuela

Pereira

et al. 2023

JPM

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Background: Forty percent of women will experience prolapse in their lifetime. Vaginal pessaries are considered the first line of treatment in selected patients. Major complications of vaginal pessaries rarely occur. Methods: PubMed and Embase were searched from 1961 to 2022 for major complications of vaginal pessaries using Medical Subject Headings (MeSH) and free-text terms. The keywords were pessary or pessaries and: vaginal discharge, incontinence, entrapment, urinary infections, fistula, complications, and vaginal infection. The exclusion criteria were other languages than English, pregnancy, complications without a prior history of pessary placement, pessaries unregistered for clinical practice (herbal pessaries), or male patients. The extracted data included symptoms, findings upon examination, infection, type of complication, extragenital symptoms, and treatment. Results: We identified 1874 abstracts and full text articles; 54 were assessed for eligibility and 49 met the inclusion criteria. These 49 studies included data from 66 patients with pessary complications amenable to surgical correction. Clavien–Dindo classification was used to grade the complications. Most patients presented with vaginal symptoms such as bleeding, discharge, or ulceration. The most frequent complications were pessary incarceration and fistulas. Surgical treatment included removal of the pessary under local or general anesthesia, fistula repair, hysterectomy and vaginal repair, and the management of bleeding. Conclusions: Pessaries are a reasonable and durable treatment for pelvic organ prolapse. Complications are rare. Routine follow-ups are necessary. The ideal patient candidate must be able to remove and reintroduce their pessary on a regular basis; if not, this must be performed by a healthcare worker at regular intervals.

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Stones of the Urethra, Prostate, Seminal Vesicle, Bladder, and Encrusted Foreign Bodies

Schwartz¹

Urinary Stone Disease

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Urinary incontinence secondary to a vaginal pessary

Cited by 10 publications

References 0 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

Complications of Pessaries Amenable to Surgical Correction: Two Case Reports and a Systematic Review of the Literature

Stones of the Urethra, Prostate, Seminal Vesicle, Bladder, and Encrusted Foreign Bodies

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