Judith Berger1, Thierry Van den Bosch, Jan Deprest. 1. From the Departments of Obstetrics and Gynecology of the Regionaal Ziekenhuis Tienen, Belgium, and the University Hospitals K.U. Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Vaginal pessaries are effective for treating pelvic organ prolapse, and severe complications are rare. We describe an exceptional case of pessary impaction with partial expulsion. CASE: An elderly woman had mild discomfort from a pessary protruding through the perineal skin. The pessary was cut, removed, and the perineum healed uneventfully. CONCLUSION: Negligence of vaginal pessaries may result in migration to the bladder or to the rectum. This case of perineal expulsion was eventually easily treated. Although no evidence-based guidelines for pessary care exist, this rare manifestation suggests the need for follow-up on a regular basis.
BACKGROUND: Vaginal pessaries are effective for treating pelvic organ prolapse, and severe complications are rare. We describe an exceptional case of pessary impaction with partial expulsion. CASE: An elderly woman had mild discomfort from a pessary protruding through the perineal skin. The pessary was cut, removed, and the perineum healed uneventfully. CONCLUSION: Negligence of vaginal pessaries may result in migration to the bladder or to the rectum. This case of perineal expulsion was eventually easily treated. Although no evidence-based guidelines for pessary care exist, this rare manifestation suggests the need for follow-up on a regular basis.