Factors Affecting Successfulness of Vaginal Pessary Use for the Treatment of Pelvic Organ Prolapse
Orawan Lekskulchai MD*, Preecha Wanichsetakul MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Pelvic organ prolapse can cause adverse events affecting the lives of the women. Vaginal pessary is a
conservative treatment, which is not expensive and safe. For the patient with medical condition, vaginal pessary would be the
first choice of treatment.
Objective : To study the factors those affect the success of the vaginal pessary use for treatment of pelvic organ prolapse.
Material and Method: Historical data of patients who visited urogynecology clinic, Thammasat University hospital from
January 2009 through December 2013, were collected. The SPSS program was used for statistical analysis with p-value
<0.05.
Results : Of 252 women with pelvic organ prolapse, median age was 67 years (range 29-92 years). Most patients, 78.2%, had
severe POP (stage 3-4). 194 women were treated with vaginal pessary. 83.5% of these patients could use continuously more
than 3 months. The open ring was the most common using pessary. 48.1% of the patients who could use pessary continuously
can self-remove and insert the device. Anterior vaginal wall and the vaginal length were significantly higher with the
successful users. The most common complication was the presence of abnormal vaginal discharge, and more common in the
patient with donut pessary.
Conclusion : The open ring is the device that can be used easily and has fewer complications, followed by ring with support.
Short vaginal length is a factor that cannot use the pessary. It seems that relaxed anterior wall and longer vaginal length might
help hold the pessary in the vagina.
Keywords : Pelvic organ prolapse, Menopause, Vaginal pessary
