Risk factors associated with an unsuccessful pessary fitting trial in women with pelvic organ prolapse.

@article{Clemons2004RiskFA,
  title={Risk factors associated with an unsuccessful pessary fitting trial in women with pelvic organ prolapse.},
  author={Jeffrey L. Clemons and Vivian C. Aguilar and Tara A Tillinghast and Neil D. Jackson and Deborah L. Myers},
  journal={American journal of obstetrics and gynecology},
  year={2004},
  volume={190 2},
  pages={
          345-50
        }
}

Tables from this paper

Factors associated with unsuccessful pessary fitting and reasons for discontinuation in Korean women with pelvic organ prolapse
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Patients with a history of hysterectomy and advanced-stage POP are at risk for an unsuccessful fitting of the ring pessary, and vaginal erosion is the main reason for discontinued use among patients with successful pessaries.
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The ring pessary fitting can be attempted in all POP cases irrespective of stage and has an acceptable continuation rate and manageable adverse events, and is an important strategy to minimize adverse events.
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A history of previous hysterectomy is a predictor of pessary failure as are Gh+Pb on Valsalva and premenopausal status and statistical analysis was performed to assess the relationship between history, examination and imaging and pessaries success.
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The presence of advanced apical POP and previous POP surgery are risk factors for ring pessary dislodgment in women with advanced pelvic organ prolapse and this information should guide physicians for counseling patients before pessaries insertion.
Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice
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Pessary fitting was successful in 58 %, indicating that pessary treatment may be suitable for many, but not for all women in general practice with symptomatic prolapse, as demonstrated by the association with underactive pelvic floor muscles, and body mass index.
Is hysterectomy or prior reconstructive surgery associated with unsuccessful initial trial of pessary fitting in women with symptomatic pelvic organ prolapse?
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It seems conclusive to recommend pessary treatment as a general first-line therapy for symptomatic POP, since after unsuccessful pessaries treatment, women can still undergo surgery, whereas reversing treatment options might not always be feasible.
Factors associated with long-term pessary use in women with symptomatic pelvic organ prolapse
  • M. MaoT. Xu L. Zhu
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TLDR
TVL ≥ 7.5 cm and a higher baseline POPDI-6 score were independent factors associated with long-term pessary use after successful fitting in women with symptomatic POP.
Pessary fitting for pelvic organ prolapse: parameters associated with specific reasons for failure
TLDR
Complete avulsion and a small ring pessary with respect to the levator HA in Valsalva are predictors of pessaries dislodgment, whereas solitary predominant posterior compartment POP is a predictor of failure to relieve POP symptoms.
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References

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The course of pelvic organ prolapse among women using a pessary for at least 1 year is described to suggest that there may be a therapeutic effect associated with the use of a supportive pessaries.
A Survey of Pessary Use by Members of the American Urogynecologic Society
The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction.
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To evaluate the therapeutic usefulness of pessaries in patients with pelvic relaxation, a retrospective study was performed identifying 107 patients who had been fitted with a pessary for symptomatic