Most women stuck with pessary treatment for symptomatic pelvic organ prolapse (POP), according to a long-term study.
In a prospective study of 312 Chinese women with symptomatic POP, 75% continued with pessary treatment — either with a ring or Gellhorn pessary — 5 years after initial fitting, reported Lan Zhu, MD, of Peking Union Medical College Hospital in Beijing, and colleagues.
Appearing in Menopause, the journal of the North American Menopause Society (NAMS), the researchers pinpointed certain factors that were tied to a higher chance of women discontinuing pessary treatment.
These included having a vaginal length less then 7.5 cm (OR 2.7, 95% CI 1.3-5.7, P=0.007) and being unable to care for themselves (OR 2.6, 95% CI 1.3-5.1, P=0.008). In addition, having less than a 50% improvement in Urinary Impact Questionnaire-7 scores by the third month after initial fitting was also tied to a significantly higher chance of discontinuation (OR 2.1, 95% CI 1.1-4.2, P=0.025).
“Current guidelines and recommendations suggesting that women with symptomatic POP should be offered a vaginal pessary as an alternative to surgery are based on its effectiveness in short- and intermediate-term studies,” Zhu’s group pointed out, adding that the prevalence of POP is expected to increase 46% by 2050 in the U.S. due to rising obesity rates among the aging population.
The group stated that if healthcare providers are aware of the specific predictors of long-term pessary discontinuation, they can help determine which patients are better suited for surge