Cross sectional study on assessment of ring pessary cleaning and removal every six months: adverse events and complications

Author(s)

de Albuquerque Coelho, Suelene Costa ^[1] ; Pereira, Glaucia Miranda Varella ^[1] ; Brito, Luiz Gustavo Oliveira ^[1] ; Juliato, Cassia Raquel Teatin ^[1]

Affiliation

^[1] Univ Estadual Campinas, Sch Med Sci, Dept Obstet & Gynecol, CAISM Div Gynecol, Rua Alexander Fleming 101, Cidade Univ, BR-13083881 Campinas - Brazil

• Document type: Journal article
• Source: INTERNATIONAL UROGYNECOLOGY JOURNAL; v. 33, n. 2, p. 397-403, FEB 2022.
• Web of Science Citations: 0

Abstract

Introduction and hypothesis Despite its frequent use, there is little evidence of adequate management of pessaries for treating pelvic organ prolapse (POP). Thus, the aims the study were to assess the rate of complications in women using ring-type pessaries with cleaning and monitoring every 6 months and to correlate the time of use of the pessary with possible complications. Methods This is a cross-sectional study including women diagnosed with stage 3 or 4 genital prolapse, who were already in outpatient follow-up and who used a ring pessary. We excluded patients using another type of pessary, with severe comorbidities and with POP-Q <= 2 staging. The chi-square test or Fisher exact test was applied for categorical variables, the t-test for continuous variables with normal distribution and Mann-Whitney test for non-parametric variables. Results A total of 83 women using a ring pessary were assessed. The mean in months of pessary use was 31.8 +/- 14.9 months. Vaginal discharge was the most frequent complaint representing 26.5%, followed by foul smell in 13.3%. No significant correlation was found between length of pessary use and clinical variables. However, a significant correlation was found between immediate complications and the length of pessary use (21.3 +/- 5.9 months; p < 0.0044). Conclusion There was no increase in complication rate in the continuous use of a ring pessary with cleaning and monitoring every 6 months. Determining a follow-up time that reduces the risk of complications is necessary not only for the organization of the attendance services, allowing a greater number of monitored patients, but also for the access of patients who need regular monitoring. (AU)

• FAPESP's process: 19/26723-5 - Effect of fractional microablative radiofrequency and pelvic floor muscle training in the treatment of women with of vaginal laxity: randomized clinical trial
• Grantee: Glaucia Miranda Varella Pereira
• Support Opportunities: Scholarships in Brazil - Doctorate