Use of pessary in the treatment of pelvic floor dysfunctions: a systematic review

Abstract

Introduction. To describe and evaluate the scientific evidence on the use of pessary in the treatment of pelvic floor dysfunctions.Methods. This systematic review was performed in accordance with the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRiSMA) guidelines. The databases searched were Sciencedirect, PubMed, PEdro, and BVS. The following descriptors were used: 'clinical trial,' 'pessary,' 'pelvic floor,' and the Boolean operator 'and.' The search was conducted between November 2016 and February 2017. The methodological quality of the selected articles was analysed with the Physiotherapy Evidence database (PEdro) scale.Results. After the insertion of the filters in the databases, 379 titles were selected, of which 5 articles were picked out in pairs for analysis as a whole. The 3 studies investigating the use of pessary in the treatment of pelvic organ prolapse included women with prolapse stages ii-iii. The rings or Gellhorn pessaries were the most frequently used, and all showed benefits in decreasing urinary symptoms and improvement of prolapse.Conclusions. The pessary is beneficial for the treatment of urinary incontinence and pelvic organ prolapse. Good methodological quality was also identified in most studies included.