Clinical study on silicone pessary in the treatment of pelvic organ prolapse

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Author:
YANG Jun-fang(Department of Obstetrics and Gynecology,Third Hospital Peking University, Beijing 100191, China)
HAN Jin-song(Department of Obstetrics and Gynecology,Third Hospital Peking University, Beijing 100191, China)
ZHU Fu-li(Department of Obstetrics and Gynecology,Third Hospital Peking University, Beijing 100191, China)
WANG Yi-ting(Department of Obstetrics and Gynecology,Third Hospital Peking University, Beijing 100191, China)
YAO Ying(Department of Obstetrics and Gynecology,Third Hospital Peking University, Beijing 100191, China)
QIAO Jie(Department of Obstetrics and Gynecology,Third Hospital Peking University, Beijing 100191, China)
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
Volume 47, Issue 07, 2012
DOI:
10.3760/cma.j.issn.0529-567x.2012.07.003
Key Word:
Pessaries; Pelvic organ prolapse; Quality of life; Patient satisfaction

Abstract: Objective To evaluate the therapeutic effect and influence factors of silicone pessary in treatment of pelvic organ prolapse ( POP).Methods From October 2005 to October 2010,132 with symptomatic POP managed by pessary were enrolled in this retrospective study.Validated prolapse quality of life questionnaire (pelvic floor distress inventory short form 20,PFDI-20),pelvic floor impact questionnaire short form 7 (PFIQ-7) and the patients' satisfaction degree were used to evaluate the therapeutic effect.Clinical characteristic of the patients with successful using for more than 6 months ( successful fitting group),giving up within 6 months (giving up group),unsuccessful fitting (unsuccessful fitting group)were compared.Factors influencing satisfaction degree and causing discontinuation were investigated.Results One hundred and six among 132 ( 106/132,80.3% ) patients were in successful fitting group,26 (26/132,19.7% ) patients were in the unsuccessful fitting group.In the successful fitting group,86.8% (92/106) patients were followed up,the median follow-up time was 12.5 months.And 78.3% ( 72/92 ) patients continued to use pessary with the wearing time ranged 3 -69 months; 21.7% (20/92) patients discontinued with the wearing time ranged 1 -38 month,14 patients (14/20) gave up in the initial 6 months.The median scores of PFDI-20 and PFIQ-7 questionnaires before pessary use were 50.0 and 47.6,which decreased to 8.9 and 0.0 after pessary use (P<0.05).And 87.1% (61/70) patients were satisfied.There was no significantly difference among 3 groups on clinical characteristics,such as age,body mass index ( BMI ),pelvic surgery and so on (P > 0.05 ).The main factor influencing satisfaction degree and causing discontinuation was difficulties in placing and removing.Conclusions Silicone pessary is effective for patients with POP.It could relieve discomfort symptoms and improve quality of life.The main factorinfluencing pessary use is difficulties in placing and removing.Thus,More suggestions are needed for patients in the initial 6 months.

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