Adherence to support pessary in the treatment of pelvic organ prolapse: a retrospective study conducted among 1,371 women

Abstract

Introduction and hypothesisThe objective was to investigate the adherence to pessary treatment in women with pelvic organ prolapse (POP) who were found eligible for this treatment by the urogynecologist, at the first visit at the Department of Gynecology and Obstetrics, Odense University Hospital.MethodsData were extracted from the women’s medical records. Frequency tabulations were performed to describe the women’s reasons for pessary discontinuation by age group. Binominal logistic regression analysis was conducted to investigate how women’s age, POP characteristics, urogynecological history, and their pessary experience and management were associated with continued pessary use.ResultsThis study included 1,371 women treated with support pessary. Of these, 850 women continued pessary treatment and 521 women underwent surgical treatment. A history of hysterectomy (OR: 0.68, 95% CI: 0.51–0.90, p = 0.008), urinary incontinence (OR: 0.71, 95% CI: 0.56–0.89, p = 0.003), and previous pessary use (OR: 0.75, 95% CI: 0.56–0.99, p = 0.047) were significant factors associated with discontinuation. Further, women aged 81–99 years were significantly more likely to continue pessary treatment (OR: 1.77, 95% CI: 1.15–2.74, p = 0.009). “POP surgery,” “prolapse stage,” and “prolapse predominant compartment” were not associated with discontinuation. Approximately 38% of women aged 26–54 years discontinued owing to personal preference.ConclusionsHysterectomy, incontinence, and previous pessary use are significant predictors of pessary discontinuation. Increasing age is significantly associated with pessary continuation.