A prospective study of pessary use for severe pelvic organ prolapse: 3-year follow-up outcomes

被引:7
|
作者
Li, Bin [1 ]
Chen, Qiaohua [2 ]
Zhang, Jing [1 ]
Yu, Cuige [1 ]
Zhang, Lu [1 ]
Chen, Lihong [1 ]
机构
[1] Shaanxi Prov Peoples Hosp, Dept Gynecol, Xian, Shaanxi, Peoples R China
[2] Air Force Med Univ, Dept Burns & Cutaneous Surg, Affiliated Hosp 1, Xian, Shaanxi, Peoples R China
基金
中国国家自然科学基金;
关键词
Pelvic organ prolapse; Pessary; Questionnaire; URINARY-INCONTINENCE; PATIENT CHARACTERISTICS; VAGINAL PESSARIES; RING PESSARY; WOMEN; MANAGEMENT; SYMPTOMS; SURGERY;
D O I
10.1007/s00404-020-05526-1
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Purpose To estimate the optimal definition of successful pessary use and the long-term success rate of the pessary as well as the complications and factors associated with continued pessary use. Methods Consecutive patients who had symptomatic stage III/IV POP were enrolled. The degrees of POP were assessed by POP-Q. All patients completed the PFIQ-7 questionnaire before pessary use. For the 1-week, 1-month, 3-month, 6-month, 1-year and 3-year follow-up assessments, patients visited the clinic for an examination and to complete the questionnaire. SPSS 18.0 was used for the data analysis. Wilcoxon's signed-rank test was performed to estimate the change in PFIQ-7 scores before and after pessary use. Logistic regression was performed to identify the factors associated with the duration of pessary use. Results A total of 60 subjects (average age 68.93 +/- 8.98 years) were enrolled. The 3-year success rate of the pessary was 63.33%. The PFIQ-7 score in the 1-month follow-up was significantly decreased (16.22 +/- 12.81 vs 1.39 +/- 3.39, P = 0.000). During the follow-up, none of the patients experienced any severe complications, and the rate of vaginal erosion was 20% (12/60). The PFIQ-7 score in the 1-month follow-up decreased more than 50% and was associated with continuous pessary use [OR 20.75, P = 0.027, 95% CI (2.28, 189.27)]. Conclusions Successful pessary use can be defined as fitting for longer than 3 months. The PFIQ-7 scores should be focused on during the follow-up. The treatment should be changed if the scores decrease less than 50% in the 1-month follow-up.
引用
收藏
页码:1213 / 1218
页数:6
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