The Clinical Study About Pessary Treatment For Women With Pelvic Organ Prolapse

Objective:To probe the effectiveness of pessary treatment for women with pelvic organ prolapsed(POP), and analyze factors which influence the the success of treatment.Methods:Between January 2008 and December 2010,55 POP patients who interested in pessary treatment and fulfilled the inclusion criteria received the implementation of pessary. They were required to complete the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after implementation of pessary in 1 month,3 months for evaluation.Results:The average age of all 55 patient enrolled was 64.4 years. Nine patients was stageⅡ,33 cases stageⅢ, and 13 stage IV according to the Pelvic Organ Prolapse Quantification(POP-Q) system, they were followed up for from 3 days to 26 months. The successful rates of satisfactory pessary fitting over 3 days,1 months and 3 months were 83.6%(46/55),78.2%(43/55) and 60.0%(33/55) respectively. There was no significant difference in age, body mass index (BMI), total vaginal length, genital hiatus, POP-Q stage, predominat compartment of prolapse, and pessary type between successful group and failure group. Compared to failure group, there were significant difference in years after postmenoposal (16.22±9.19 vs 24.00±10.14, p<0.05), duration of disease(7.35±8.64 vs 15.58±12.06, p<0.05), parity(3.69±1.67 vs 3.79±1.36, p<0.05), length of perineal body(3.63±1.05 vs 2.13±1.51, p<0.05) in successful group. In successful group at 1 month PFDI-20 total score decreased from baseline (119.54±39.30) to (57.41±21.07) (p<0.05), POPDI-6(Pelvic organ prolapse distress inventory) from (13.96±4.46) to (3.44±1.65) (p<0.05), CARDI-8(Colorectal anal distress inventory 8) from (10.04±4.26) to (6.81± 2.42) (p<0.05), and UDI-6(Urinary distress inventory 6) score from (9.19±3.03) to (5.22±2.33) (p<0.05), respectively. There was no significant difference in PFDI-20 score between 1 month and 3 month after treatment.Conclusion:Pessary is an effective and first line method of alleviating symptoms of pelvic organ prolapse and associated pelvic floor dysfunction, and improve the life quality of patients. Successful implementation of pessary is associated with the length of pereneal body, duration of disease, parity, and years after postmenoposal. The type and severity of POP do not influence the likelihood of a successful pessary fitting.