Satisfaction des patientes et efficacité du pessaire en cas de prolapsus des organes pelviens

Abstract

Pessary is one of the commonly used conservative treatments of pelvic organ prolapse (POP). However, its use seems to be limited to elderly patients or in case refusal or contraindication to surgery. Our main objective was to evaluate and identify factors associated with satisfaction in women using a pessary. Secondary objectives were to assess improvement in symptom and quality of live scores and to identify factors associated with unsucessfull pessary use. This was a prospective cohort study performed in a French teaching hospital in women with symptomatic POP. The primary endpoint was the PGI-I (Patient Global Impression of Improvement). Symptom improvement was assessed using the symptom scores (PFDI-20, ICIQ-SF, PISQ-12 and USP) and the PFIQ-7 quality of life score. Eighty five patients were included. The satisfaction rate was 78,1% at 1 month and 87,5% at 6months. The effectiveness of pessary was the main benefit reported by patients at both 1month (60%) and 6 months (59,4%). The only factors associated witch patient satisfaction were the greater improvement in symptoms (PFDI20 et PFIQ7; p<0.05). In case of failure, patients were significantly younger and overweight (p=0.001). The pessary is a true first-line treatments alternative of POP without major complications. Patient acceptance and satisfaction are important.