title: A 5-year prospective study of vaginal pessary use for pelvic organ prolapse.
abstract: OBJECTIVE
  To evaluate prospectively the use of vaginal pessaries for pelvic organ prolapse (POP) and to identify complications and reasons for discontinuing pessary use over a 5-year period.
  
  
  METHODS
  A prospective observational study was conducted among all women with POP referred to the urogynecology clinic of a UK hospital between June 2002 and June 2005 who opted to use a vaginal pessary. Patients were followed-up for 5 years.
  
  
  RESULTS
  Of the 246 women who chose to use a vaginal pessary, 187 successfully retained the pessary 4 weeks after insertion. Over a 5-year period, 36 (19.3%) of the 187 women were lost to follow-up. Of the 151 women included in the analysis, 21 (13.9%) discontinued use at some point after 4 weeks, whereas 130 (86.1%) used the pessary successfully over 5 years. Overall, 12.1% of the women experienced minor complications (6.9% pain or discomfort, 3.2% excoriation or bleeding, and 2.0% disimpaction or constipation). Most failures (73.8%) occurred within 4 weeks of pessary insertion. After cessation of pessary use, 70 (28.5%) of the 246 women chose surgery and 10 (4.1%) chose no further treatment.
  
  
  CONCLUSIONS
  If treatment of POP with a vaginal pessary is successful at 4 weeks, most women will continue to use the pessary over 5 years without a concomitant increase in complications.
authors.affiliation: Department of Obstetrics and Gynecology, Mayday University Hospital, Surrey, UK.
authors.forename: Farah
authors.initials: F
authors.lastname: Lone
authors.forename: Ranee
authors.initials: R
authors.lastname: Thakar
authors.forename: Abdul H
authors.initials: AH
authors.lastname: Sultan
authors.forename: George
authors.initials: G
authors.lastname: Karamalis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D010570:Pessaries / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D006113:United Kingdom; D014621:Vagina; D055815:Young Adult