Vaginal pessaries in urinary incontinence: integrative review

Priscilla Daun De Assis De Oliveira,Neusa Maria Costa Alexandre,Néria Invernizzi Da Silveira,Sonia Regina Pérez Evangelista Dantas,Carolina Bueno Somense,Eliana De Fatima Martins Greghi,Natalia Aparecida De Barros

doi:10.30886/estima.v16.661_in

Priscilla Daun De Assis De Oliveira, Neusa Maria Costa Alexandre + Show 5 more

Open Access

https://doi.org/10.30886/estima.v16.661_in

Copy DOI

Abstract

Objectives: To analyze the types of pessaries, indications and impact in the treatment of urinary incontinence (UI). Methods: This is an integrative review with publications from 2007 to 2017 indexed in the Biblioteca Virtual em Saúde, Medical Literature Analysis and Retrieval System Online databases, Scopus Info Site, Cumulative Index to Nursing and Allied Health Literature and Web of Science. Results: Eight articles were selected. The pessaries indicated were the dish, ring, Uresta®, and Contiform®. The reduction or resolution of stress UI in women was observed by analysis of objective parameters such as urodynamic evaluation and quality of life questionnaires. Economic viability was highlighted. Disability, difficulties in use, discomfort, and maintenance of urinary losses were evidenced among the reasons for non-adherence. Advanced prolapse and short vaginal length were predictive of failure. Adverse events were identified in low incidence: urinary retention and leukorrhea. Conclusion: Pessary therapy is effective in the treatment of SUI when accompanied by trained professionals. Individual characteristics and perceptions about the device are determinants of therapeutic success. Studies of greater sampling, follow-up time and quality, as well as stimulation to national publications, are necessary for the investigation of objective measures of UI, clinical and demographic factors in relation to the success of the pessary.

Highlights

By 2018, an estimated 120 million men and 301 million women are suffering from urinary incontinence (UI), involuntary loss of urine[1,2]
E literature indicates impairment of quality of life (QoL); a Brazilian study identi ed a serious impairment in daily living activities in 63.9% of women su ering from SUI4 and U.S study linked UI to increased risk for depression and disability[5]
Uresta®significantly reduced urinary incontinence (UI); Easy to use, with improved quality of life (QoL); Results demonstrated with objective measures: Pad test, Incontinence Impact Questionnaire (IIQ) and Urogenital Distress Inventory (UDI); Mechanism of action: mechanical support to the urethra; The need for larger, prospective, comparative studies with placebo effect control and analysis of interfering factors in the success of therapy

Summary

Introduction

By 2018, an estimated 120 million men and 301 million women are suffering from urinary incontinence (UI), involuntary loss of urine[1,2]. Minimally invasive intravaginal devices, are described as a UI treatment option for women of any age group, especially those who wish to avoid or have contraindications to surgical treatment[1,6,7,8]. Among other advantages, they have a relatively low cost and risk, provide immediate relief of symptoms, and the possibility of being used in addition to other conservative therapies, such as exercises of the pelvic oor musculature. There are reports of half pomegranate soaked in vinegar (350 BC), stringwrapped sponges wrapped in wax and covered with oil or butter (1559 AD), up to current silicone models[9]

Objectives

Results

Conclusion