1193 Factors Associated with Long-Term Pessary Use in Women with Symptomatic Pelvic Organ Prolapse

Abstract

Study Objective To evaluate the continuation rate and identify predictive factors of long-term pessary use, which are essential for counseling women with symptomatic pelvic organ prolapse (POP) who seek long-term pessary treatment. Design This was a prospective observational study. The duration of follow-up was 17 to 36 months. Setting Center of obstetrics and gynecology in a tertiary-care hospital. Patients or Participants Two hundred and seventy-seven patients who had successful pessary fittings between April 2015 and November 2016 were enrolled. Interventions A vaginal pessary fitting was performed for each patient enrolled. Measurements and Main Results Baseline characteristics, prolapse symptoms and urinary symptoms were recorded. The Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) were applied to assess the extent to which all forms of pelvic floor disorders affected the patients’ QOL at baseline. The patients were assigned for routine follow-up at 3, 6, and 12 months during the first year and at 6-month intervals afterwards until the study conclusion date of April 2018. The median follow-up time was 26 months; 76.5% of patients continued to use pessaries at the study endpoint. Sixty-one patients discontinued pessary use, and almost all of them (55/61, 90.2%) discontinued pessary use within the first 12 months after the successful pessary fitting. TVL Conclusion TVL≥7.5 cm and a higher POPDI-6 score at baseline were independent predictors of long-term pessary use after successful fitting in women with symptomatic POP.