title: The cube pessary: an underestimated treatment option for pelvic organ prolapse? Subjective 1-year outcomes.
abstract: OBJECTIVE
  Pelvic organ prolapse (POP) is a common condition. The use of pessaries for conservative management of POP is widespread. However, there are little data on the use of cube pessaries. The aim of our study was to evaluate whether self-therapy with the use of vaginal cube pessaries in women with POP can be a well-tolerated, first-line treatment.
  
  
  METHODS
  In a prospective case series, 87 women who suffered from symptomatic POP, stages II-IV, were instructed in self-treatment with a vaginal cube pessary. Differences were analyzed using Wilcoxon's rank sum test or Fisher's exact test.
  
  
  RESULTS
  A pessary could be fitted in 84/87 patients (96.6%); 6 women were lost to follow-up. The remaining 78 patients (92.9%, median age 60 years) completed the study. Sixteen women (20.5%) chose not to continue with the pessary treatment. For these patients, general well-being decreased from a median numeric rating score (NRS) of 4.5 (3-6) to 2.0 (1-3, p < 0.001). In those who continued treatment, general well-being increased from a median NRS of 3.0 (2-5) to 8.0 (7-10, p < 0.001) after 1 year of use. The majority of patients (53) in the present study rated pessary self-care use as "very easy" or "easy" (85.5%). The Patient Global Impression of Improvement (PGI-I) was 2.0 (1-3) at follow-up examination. There were no complications or adverse effects of pessary use.
  
  
  CONCLUSIONS
  Conservative self-treatment with vaginal cube pessaries might be a feasible treatment option for women who suffer from POP.
authors.affiliation: Department of Gynecology, Saint John of God Hospital, Vienna, Austria.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Nemeth
authors.forename: Sándor
authors.initials: S
authors.lastname: Nagy
authors.forename: Johannes
authors.initials: J
authors.lastname: Ott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D010570:Pessaries; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome