title: The impact of pessary use on bowel symptoms: one-year outcomes.
abstract: OBJECTIVE
  The literature states that patients with pelvic organ prolapse have a higher prevalence of bothersome bowel symptoms and that surgical correction of prolapse may improve bowel function. There is limited knowledge regarding the impact of pessary use on bowel function in patients with prolapse. The aim of this study was to evaluate if there is a change in bowel symptoms in patients with prolapse treated with a vaginal pessary.
  
  
  METHODS
  Women who presented for pessary insertion completed the validated questionnaires on the bowel symptom severity and on the effect of bowel symptoms on the quality of life at baseline and again at 12 months of continuous pessary use. Inferential statistics comprised Student t test for evaluating differences in continuous Gaussian data between groups and paired t tests were used to evaluate differences among subjects between the baseline and 12 months of use.
  
  
  RESULTS
  One hundred four women participated in the original study, and 43 had complete data for analysis. Women who completed 12 months of pessary use reported significant improvements in both bowel-related symptoms and bowel-related quality of life (95% confidence interval of the difference 1.6-11.4 and 2.0-14.0, respectively). Patients who completed the 12-month follow-up were significantly older and more likely to have stage 3 or 4 prolapse than noncompleters, but there were no differences in body mass index, race, history of prior prolapse surgery, or menopause status.
  
  
  CONCLUSIONS
  In women with prolapse, the use of a pessary is associated with a decrease in complaints related to bowel symptoms.
authors.affiliation: From the *Division of Urogynecology, Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, CT; †Department of Obstetrics and Gynecology, Kaiser Permanente, Roseville, CA; and ‡Department of Research Administration, Hartford Hospital, Hartford, CT.
authors.forename: Hema D
authors.initials: HD
authors.lastname: Brazell
authors.forename: Minita
authors.initials: M
authors.lastname: Patel
authors.forename: David M
authors.initials: DM
authors.lastname: O'Sullivan
authors.forename: Colleen
authors.initials: C
authors.lastname: Mellen
authors.forename: Christine A
authors.initials: CA
authors.lastname: LaSala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D010570:Pessaries; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014621:Vagina