Meng Mao1, Fangfang Ai1, Ye Zhang1, Jia Kang1, Shuo Liang1, Tao Xu2, Lan Zhu3. 1. Departments of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 2. Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 3. Departments of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: zhu_julie@vip.sina.com.
Abstract
OBJECTIVES: The study aim was to assess the effect of treatment with a ring with support pessary on bothersome symptoms and the quality of life of patients with symptomatic pelvic organ prolapse (POP). STUDY DESIGN: In this prospective observational study, 142 patients with symptomatic POP were successfully fitted with a ring with support pessary between November 2015 and November 2016 and followed up until December 2017. Prolapse and urinary symptoms were assessed, and the Pelvic Floor Distress Inventory-20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) were administered at baseline and at each follow-up visit. Univariate analyses, McNemar's test and paired t-tests were used for data analyses. MAIN OUTCOME MEASURES: Changes in prolapse and urinary symptoms and quality of life after fitting with a ring with support pessary use. RESULTS: The median (range) duration of follow-up was 17 (13-24) months. At the study endpoint, 98 patients (74.8%) continued to use the pessaries. Wider vaginal introitus (≥5 cm) was found to be a predictor of pessary discontinuation. Although de novo stress urinary incontinence occurred in 27.1% of patients, almost all prolapse symptoms and most of the concurrent urinary symptoms were resolved, with voiding difficulty resolved most significantly. Scores on both the PFIQ-7 and PFDI-20 had significantly improved at the study endpoint, with changes in scores on the urinary and prolapse sub-scales of both questionnaires demonstrating clinical significance (effect size>0.5). CONCLUSIONS: A ring with support pessary is a safe and effective conservative treatment for POP; it not only relieves bothersome prolapse and urinary symptoms but also significantly decreases their impacts on health-related quality of life. However, the method has a limited effect on defecatory symptoms.
OBJECTIVES: The study aim was to assess the effect of treatment with a ring with support pessary on bothersome symptoms and the quality of life of patients with symptomatic pelvic organ prolapse (POP). STUDY DESIGN: In this prospective observational study, 142 patients with symptomatic POP were successfully fitted with a ring with support pessary between November 2015 and November 2016 and followed up until December 2017. Prolapse and urinary symptoms were assessed, and the Pelvic Floor Distress Inventory-20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) were administered at baseline and at each follow-up visit. Univariate analyses, McNemar's test and paired t-tests were used for data analyses. MAIN OUTCOME MEASURES: Changes in prolapse and urinary symptoms and quality of life after fitting with a ring with support pessary use. RESULTS: The median (range) duration of follow-up was 17 (13-24) months. At the study endpoint, 98 patients (74.8%) continued to use the pessaries. Wider vaginal introitus (≥5 cm) was found to be a predictor of pessary discontinuation. Although de novo stress urinary incontinence occurred in 27.1% of patients, almost all prolapse symptoms and most of the concurrent urinary symptoms were resolved, with voiding difficulty resolved most significantly. Scores on both the PFIQ-7 and PFDI-20 had significantly improved at the study endpoint, with changes in scores on the urinary and prolapse sub-scales of both questionnaires demonstrating clinical significance (effect size>0.5). CONCLUSIONS: A ring with support pessary is a safe and effective conservative treatment for POP; it not only relieves bothersome prolapse and urinary symptoms but also significantly decreases their impacts on health-related quality of life. However, the method has a limited effect on defecatory symptoms.
Authors: Claudia Manzini; Carl Huub van der Vaart; Frieda van den Noort; Anique T M Grob; Mariëlla I J Withagen Journal: Int Urogynecol J Date: 2022-01-23 Impact factor: 1.932
Authors: Claudia Manzini; Frieda van den Noort; Anique T M Grob; Mariëlla I J Withagen; Carl H van der Vaart Journal: Int Urogynecol J Date: 2021-04-13 Impact factor: 2.894
Authors: Claudia Manzini; Mariëlla I J Withagen; Frieda van den Noort; Anique T M Grob; Carl H van der Vaart Journal: Int Urogynecol J Date: 2021-09-29 Impact factor: 1.932