title: Pessary use in advanced pelvic organ prolapse.
abstract: The objective of this study was to review our experience with pessary use for advanced pelvic organ prolapse. Charts of patients treated for Stage III and IV prolapse were reviewed. Comparisons were made between patients who tried or refused pessary use. A successful trial of pessary was defined by continued use; a failed trial was defined by a patient's discontinued use. Thirty-two patients tried a pessary; 45 refused. Patients who refused a pessary were younger, had lesser degree of prolapse, and more often had urinary incontinence. Most patients (62.5%) continued pessary use and avoided surgery. Unsuccessful trial of pessary resorting to surgery included four patients (33%) with unwillingness to maintain, three patients (25%) with inability to retain and two patients (17%) with vaginal erosion and/or discharge. Our findings suggest that pessary use is an acceptable first-line option for treatment of advanced pelvic organ prolapse.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/ Montefiore Medical Center, Bronx, NY 10467, USA. kpowers@montefiore.org
authors.forename: Kenneth
authors.initials: K
authors.lastname: Powers
authors.forename: George
authors.initials: G
authors.lastname: Lazarou
authors.forename: Andrea
authors.initials: A
authors.lastname: Wang
authors.forename: Julie
authors.initials: J
authors.lastname: LaCombe
authors.forename: Giti
authors.initials: G
authors.lastname: Bensinger
authors.forename: Wilma M
authors.initials: WM
authors.lastname: Greston
authors.forename: Magdy S
authors.initials: MS
authors.lastname: Mikhail
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010358:Patient Participation; D010570:Pessaries; D011391:Prolapse; D012189:Retrospective Studies; D014596:Uterine Prolapse / Q000628:therapy*; D014782:Visceral Prolapse / Q000628:therapy