Jordan Mendelson1, Bogdan Grigorescu1,2, Catherine Quinn2, George Lazarou3,4. 1. New York University Long Island School of Medicine, Mineola, NY, USA. 2. Department of Obstetrics and Gynecology, New York University Langone Hospital-Long Island, Mineola, NY, USA. 3. New York University Long Island School of Medicine, Mineola, NY, USA. George.Lazarou@nyulangone.org. 4. Department of Obstetrics and Gynecology, New York University Langone Hospital-Long Island, Mineola, NY, USA. George.Lazarou@nyulangone.org.
Abstract
INTRODUCTION AND HYPOTHESIS: While 2017 guidelines from The American College of Obstetricians & Gynecologists called for pessary replacement every 3 to 4 months, a recent study in Obstetrics and Gynecology suggested that uninterrupted pessary use up to 6 months is not an independent risk factor for development of pessary-related complications. METHODS: Our recent experience throughout the Covid-19 pandemic highlights the potential ramifications of delayed clinical follow-up. RESULTS: During the Covid-19 pandemic, 3 of our patients developed rectovaginal fistulae secondary to Gellhorn pessary erosion in the context of delayed clinical follow-up. Our patients had previously attended routine appointments every 3 months without complications until missed appointments secondary to the pandemic led to fistulae formation. CONCLUSION: We believe that delayed clinical follow-up of pessary management beyond 3 months due to the Covid-19 pandemic may lead to fistula complications in elderly women with Gellhorn pessaries.
INTRODUCTION AND HYPOTHESIS: While 2017 guidelines from The American College of Obstetricians & Gynecologists called for pessary replacement every 3 to 4 months, a recent study in Obstetrics and Gynecology suggested that uninterrupted pessary use up to 6 months is not an independent risk factor for development of pessary-related complications. METHODS: Our recent experience throughout the Covid-19 pandemic highlights the potential ramifications of delayed clinical follow-up. RESULTS: During the Covid-19 pandemic, 3 of our patients developed rectovaginal fistulae secondary to Gellhorn pessary erosion in the context of delayed clinical follow-up. Our patients had previously attended routine appointments every 3 months without complications until missed appointments secondary to the pandemic led to fistulae formation. CONCLUSION: We believe that delayed clinical follow-up of pessary management beyond 3 months due to the Covid-19 pandemic may lead to fistula complications in elderly women with Gellhorn pessaries.
Authors: Jeffrey L Clemons; Vivian C Aguilar; Tara A Tillinghast; Neil D Jackson; Deborah L Myers Journal: Am J Obstet Gynecol Date: 2004-04 Impact factor: 8.661
Authors: Susanne D Thys; Robert A Hakvoort; Joyce Asseler; Alfredo L Milani; Astrid Vollebregt; Jan Paul Roovers Journal: Int Urogynecol J Date: 2020-01-06 Impact factor: 2.894