Use of a Pessary in Treatment of Pelvic Organ Prolapse: Quality of Life, Compliance, and Failure at 1-Year Follow-up

Ko, Po-Chun; Lo, Tsia‐Shu; Tseng, Ling-Hong; Lin, Yi‐Hao; Liang, Ching‐Chung; Lee, Shu-Jane

doi:10.1016/j.jmig.2010.09.006

Cited by 27 publications

(38 citation statements)

References 20 publications

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“…Vaginal pessaries are well tolerated and improve the symptoms associated with POP [7][8][9][10][11][12][13][14]. However, few studies used validated questionnaires [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

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Impact on quality of life after ring pessary use for pelvic organ prolapse

Manchana

Bunyavejchevin

2012

Int Urogynecol J

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“…Vaginal pessaries are well tolerated and improve the symptoms associated with POP [7][8][9][10][11][12][13][14]. However, few studies used validated questionnaires [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…However, few studies used validated questionnaires [11][12][13][14]. There is limited information on the evaluation of symptoms associated with POP and QOL with pessary using P-QOL questionnaires.…”

Section: Discussionmentioning

confidence: 99%

Impact on quality of life after ring pessary use for pelvic organ prolapse

Manchana

Bunyavejchevin

2012

Int Urogynecol J

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“…Five single-center parallel group RCTs were included in the present systematic review: Four were conducted in Italy [36–39] and one in Israel [40]. All five trials used two comparison groups.…”

Section: Resultsmentioning

confidence: 99%

Anti-adhesion barrier gels following operative hysteroscopy for treating female infertility: a systematic review and meta-analysis

et al. 2014

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The aim of this study was to assess the effects of any anti-adhesion barrier gel used after operative hysteroscopy for treating infertility associated with uterine cavity abnormalities. Gynecologists might use any barrier gel following operative hysteroscopy in infertile women for decreasing de novo adhesion formation; the use of any barrier gel is associated with less severe de novo adhesions and lower mean adhesion scores. Nevertheless, infertile women should be counseled that there is at the present no evidence for higher live birth or pregnancy rates. There is a lack of data for the outcome miscarriage. Preclinical studies suggest that the use of biodegradable surgical barriers may decrease postsurgical adhesion formation. Observational studies in the human report conflicting results. We searched the Cochrane Menstrual Disorders and Subfertility Specialized Register (10 April 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 1), MEDLINE (1950 to 4 April 2013), EMBASE (1974 to 4 April 2013), and other electronic databases of trials including trial registers, sources of unpublished literature, and reference lists. We handsearched the Journal of Minimally Invasive Gynecology (from 1 January 1992 to 13 April 2013); we also contacted experts in the field. We included the randomized comparisons between any anti-adhesion barrier gel versus another barrier gel, placebo, or no adjunctive therapy following operative hysteroscopy. Primary outcomes were live birth rates and de novo adhesion formation at second-look hysteroscopy. Secondary outcomes were pregnancy and miscarriage rates, mean adhesion scores, and severity of adhesions at second-look hysteroscopy. Two authors independently assessed eligible studies for inclusion and risk of bias, and extracted data. We contacted primary study authors for additional information or other clarification. Five trials met the inclusion criteria. There is no evidence for an effect favoring the use of any barrier gel following operative hysteroscopy for the key outcomes of live birth or clinical pregnancy (risk ratio (RR) 3.0, 95 % confidence interval (CI) 0.35 to 26, P = 0.32, one study, 30 women, very low quality evidence); there were no data on the outcome miscarriage. The use of any gel following operative hysteroscopy decreases the incidence of de novo adhesions at second-look hysteroscopy at 1 to 3 months (RR 0.65, 95 % CI 0.45 to 0.93, P = 0.02, five studies, 372 women, very low quality evidence). The number needed to treat to benefit is 9 (95 % CI 5 to 33). The use of auto-cross-linked hyaluronic acid gel in women undergoing operative hysteroscopy for fibroids, endometrial polyps, or uterine septa is associated with a lower mean adhesion score at second-look hysteroscopy at 3 months (mean difference (MD) −1.44, 95 % CI −1.83 to −1.05, P < 0.00001, one study, 24 women; this benefit is even larger in women undergoing operative hysteroscopy for intrauterine adhesions(MD −3.30, 95 % CI −3.43 to −3.17, P < 0.00001, one study, 19 women). A...

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“…[5] Prior studies have revealed that pessaries are an effective form of treatment resulting in improvement of symptoms and in quality of life. [6-10] However, most research has focused on the relief of physical symptoms associated with pessary use, highlighting the need for qualitative studies that concentrate on the subjective experience of women using a pessary. Moreover, none of these investigations accounted for racial differences within the study groups and as a result it is unknown if ethnicity influences the experience of pessary use in women with POP.…”

Section: Introductionmentioning

confidence: 99%

The pessary process: Spanish-speaking Latinas’ experience

Sevilla¹,

Wieslander

Alas

et al. 2012

Int Urogynecol J

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Introduction Little is known about women’s experience with conservative management of pelvic organ prolapse. We sought to understand the experiences of Spanish-speaking women who choose a pessary. Methods Spanish-speaking women from a urogynecologic pessary clinic were recruited for this study. Interviews were conducted and the women were asked about their pessary experience including questions involving symptom relief, pessary management, and quality of life. All interview transcripts were analyzed using the qualitative methods of Grounded Theory. Results Sixteen Spanish-speaking women who had been using a pessary for at least one month were enrolled in this study. Grounded theory methodology yielded several preliminary themes, in which one major concept emerged as a pessary adjustment process. In this process patients had to first decide to use a pessary, either because of physician’s recommendations or out of personal choice. Second, the patients entered an adjustment period in which they learned to adapt to the pessary, both physically and mentally. Lastly, if the patients properly adjusted to wearing a pessary they experienced relief of bothersome symptoms. Conclusions Our findings demonstrate that Spanish-speaking women go through a process in order to adjust to a pessary. Furthermore, the physician has a major role in not only determining a woman’s decision to use a pessary, but also whether she can adjust to wearing the pessary. This process is most successful when patients receive comprehensive management from a healthcare team of physicians and nurses who can provide individualized and continuous pessary care.

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Use of a Pessary in Treatment of Pelvic Organ Prolapse: Quality of Life, Compliance, and Failure at 1-Year Follow-up

Cited by 27 publications

References 20 publications

Impact on quality of life after ring pessary use for pelvic organ prolapse

Impact on quality of life after ring pessary use for pelvic organ prolapse

Anti-adhesion barrier gels following operative hysteroscopy for treating female infertility: a systematic review and meta-analysis

The pessary process: Spanish-speaking Latinas’ experience

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