title: Incontinence pessaries: size, POPQ measures, and successful fitting.
abstract: OBJECTIVE
  The aim of the study was to determine whether successful incontinence pessary fitting or pessary size can be predicted by specific POPQ measurements in women without advanced pelvic organ prolapse.
  
  
  METHODS
  In a multicenter study, women with stress urinary incontinence (SUI) and POPQ stage < or = 2 were randomized to three treatment arms: (1) incontinence pessary, (2) behavioral therapy, or (3) both. This study evaluates incontinence pessary size, POPQ measures, and successful fitting in the 266 women assigned to treatment arms 1 and 3.
  
  
  RESULTS
  Two hundred thirty-five women (92%) were successfully fitted with an incontinence ring (n = 122) or dish (n = 113). Hysterectomy, genital hiatus (GH), and GH/total vaginal length (TVL) ratios did not predict unsuccessful fitting (p > 0.05). However, mean TVL was greater in women successfully fitted (9.6 vs. 8.8 cm, p < 0.01). Final pessary diameter was not predicted by TVL, point D, or point C (p > 0.05).
  
  
  CONCLUSIONS
  The vast majority of women with SUI can be successfully fitted with an incontinence pessary, but specific POPQ measures were not helpful in determining incontinence pessary size.
authors.affiliation: Department of Reproductive Medicine, University of California, San Diego, San Diego, CA, USA. cnager@ucsd.edu
authors.forename: Charles W
authors.initials: CW
authors.lastname: Nager
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Ingrid
authors.initials: I
authors.lastname: Nygaard
authors.forename: Marie Fidela
authors.initials: MF
authors.lastname: Paraiso
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kenton
authors.forename: Shanna D
authors.initials: SD
authors.lastname: Atnip
authors.forename: Cathie
authors.initials: C
authors.lastname: Spino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010570:Pessaries; D010808:Physical Examination; D012720:Severity of Illness Index; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000628:therapy*; D014621:Vagina / Q000033:anatomy & histology; D055815:Young Adult