Abstract
Introduction: A common disorder among elderly ladies which causes urinary, gastrointestinal, sexual, and local symptoms is pelvic organ prolapse (POP). Two methods that include surgical and non-surgical (conservative) for POP treatment are recommended. Pessary is a advantageous and effective conservative treatment for POP. In this research the purpose was to assess the effect of pessary on concomitant symptoms of POP. Materials and Methods: In this paper randomized clinical trial (before and after), 120 patients had pessary implanted and completed study. In order to evaluate side effects following pessary use, especially urinary symptoms and their type and treatment, primary symptoms’ improvement and patients’ satisfaction were recorded with SPSS software version 17. For this purpose descriptive statistical methods such as abundance, median, ratio, standard deviation were applicated. Paired Samples t-test for quantity comparison before and after data results and for quality comparison intervention before and after data results were also applied using the McNemar Statistical test. A p-value of ≤0.05 was considered to be statistically significant. Results: Complications after embedment pessary occurred in 50.8%, with vaginal infection being the more prevalent and constipation and stress incontinence as the lower prevalent ones. Most complications occurred from the first trimester. Conclusion: Pessary application for improvement of POP accompanied with significant treatment of urinary sign and mass bulging increases the quality of life and patients’ satisfaction. Along with improvement of symptoms, pessary application has limited lower complications, indicative of advantageous and effectiveness of this device.
Highlights
The pessary has been recommend by obstetricians for treatment of symptoms of pelvic organ prolapse (POP)
The American Urogynecologic Society reported that approximately 66% of physicians would choose the vaginal pessary over surgery as the first-line treatment for POP diseases [3]
Complications occurred in 50.8% of patients after using pessary; vaginal infection was the most common and less common were constipation and stress-associated urinary incontinence
Summary
The pessary has been recommend by obstetricians for treatment of symptoms of pelvic organ prolapse (POP). It is a chronic intra-pelvic organs disorder with a high prevalence among elderly ladies. The American Urogynecologic Society reported that approximately 66% of physicians would choose the vaginal pessary over surgery as the first-line treatment for POP diseases [3]. In this study compared the treatment of POP with very low use of pessary method which has not been performed, and similar studies on this topic have not yet been published in Iran.
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