title: Does a ring pessary in situ influence the pelvic floor muscle function of women with pelvic organ prolapse when tested in supine?
abstract: OBJECTIVE
  It has been suggested that repositioning pelvic organ prolapse (POP) by pessary support may improve pelvic floor muscle (PFM) function. The aim of the present study was to compare vaginal resting pressure and maximal voluntary contraction (MVC) of the PFM measured with and without a ring pessary in situ.
  
  
  METHODS
  This was a short-term experimental study with women acting as their own controls. Twenty-two women with POP quantified II-IV were included. Vaginal resting pressure and MVC was measured with a manometer (Camtech AS) in supine position. Difference between measurements with and without the ring pessary was analyzed by paired sample t test and Wilcoxon signed rank test. Significance level was <0.05.
  
  
  RESULTS
  There was a statistically significant difference in measurement of vaginal resting pressure (p <0.01) but not of MVC (p= <0.68) with the ring pessary in situ.
  
  
  CONCLUSIONS
  Measurement of PFM strength can be done without repositioning the prolapse.
authors.affiliation: Department of Sports Medicine, Norwegian School of Sports Sciences, Akershus University Hospital, Lorenskog, Norway. kari.bo@nih.no
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.forename: Memona
authors.initials: M
authors.lastname: Majida
authors.forename: Marie Ellstrøm
authors.initials: ME
authors.lastname: Engh
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D017773:Pelvic Floor / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000503:physiopathology*; D010570:Pessaries; D012146:Rest / Q000502:physiology; D016683:Supine Position / Q000502:physiology*
references.citation: Obstet Gynecol. 2008 Sep;112(3):630-6
references.pmid: 18757662
references.citation: Int Urogynecol J. 2011 Apr;22(4):461-8
references.pmid: 20960148
references.citation: Am J Obstet Gynecol. 1996 Jul;175(1):10-7
references.pmid: 8694033
references.citation: BJOG. 2009 Dec;116(13):1706-14
references.pmid: 19906017
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2006 Jun;17(4):365-71
references.pmid: 16205845
references.citation: Obstet Gynecol. 2008 Mar;111(3):678-85
references.pmid: 18310371
references.citation: Best Pract Res Clin Obstet Gynaecol. 2005 Dec;19(6):895-911
references.pmid: 16185930
references.citation: Obstet Gynecol. 2010 Feb;115(2 Pt 1):317-324
references.pmid: 20093905
references.citation: Am J Obstet Gynecol. 2009 Feb;200(2):184.e1-7
references.pmid: 19110218
references.citation: Ann Readapt Med Phys. 2008 Mar;51(2):96-102
references.pmid: 18242753
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2009 Jan;20(1):45-51
references.pmid: 18806910
references.citation: J Med Assoc Thai. 2003 Jun;86(6):509-15
references.pmid: 12924798
references.citation: Am J Obstet Gynecol. 2010 Aug;203(2):170.e1-7
references.pmid: 20435294
references.citation: Obstet Gynecol. 2007 Feb;109(2 Pt 1):295-302
references.pmid: 17267827
references.citation: JAMA. 2008 Sep 17;300(11):1311-6
references.pmid: 18799443
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2005 Nov-Dec;16(6):497-503
references.pmid: 15986100
references.citation: Acta Obstet Gynecol Scand. 2003 Dec;82(12):1120-4
references.pmid: 14616257
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2002 Nov;13(6):349-51; discussion 352
references.pmid: 12466904