The Clinical Study About Pessary Treatment For Elderly Female With Pelvic Organ Prolapse

Objective: To study the effectiveness of pessary treatment for elderly women wtih pelvic organ prodrome,and evaluate the clinical value of pessary in elderly POP patients.Methods: From June 2016 to December 2017,47 elderly women patients wtih POP were collected,who received pessary treatments in Jiangxi Province Maternity and Child Health Hospital care outpatient departments of with senile female POP.According to the POP-Q ststem,degree of prolapse was divided into I,II,III and IV degrees.The clinical data of patients were collected including patient's age,history of pregnancy,body mass index,history of pelvic surgery,whether incorporate diabetes mellitus or not,and the history of mental illness ect,and discuss the factors influencing the treatment of pessary.After pessary successful placemented,patients were followed-up by telephone and outpatient visit follow-up,patients' information like pessary regular using,self-conscious symptom and reasons of treatment termination.Patient's quality of life before and after the pessary treatment were evaluated by methods of pelvic floor disorders affect the simple questionnaire 7(PFIQ-7),and the related factors influencing the pessary treatment for clinical analysis.Results: 1.the age of 47 patients with POP was 64~89,most of them were in ages of 70~79 years old,accounting for 38.3%(18/47).All the patients were postmenopausal,and the number of postmenopausal years was 30.39±6.65.After the pessary trial;2.37 cases were successfully placed in the uterus,with a success proportion of 78.72%(37/47);3.During pessary treatment,there were 5 patients with increased vaginal secretion and 2 patients with vaginal bleeding.After corresponding treatment such as daily cleaning or local application of estriol ointment or topical anti-inflammatory,all these patients continued the pessary treatmenthad with signicicant improved clinically symptoms;4.According to the standard of POP-Q,19 cases of POP-Q II degree,12 cases of POP-Q III degrees and 3 cases of POP-Q IV degrees were in the successful group.In the failure group,there were 4 cases ofPOP-Q II degree,6 cases of POP-Q III degree and 1 cases of POP-Q IV.Statistical analysis shown that no significant difference was found in the POP-Q degrees between the two groups(P>0.05).After pessary treatment for 3 months and 6 months,we found that the pelvic organ prolapse degree of patients compared with before treatment,has a tendency to reduce but the difference was not statistically significan(P > 0.05);5.The total score of PFIQ-7 before treatment was 92.17±28.95,and the total score was significantly lower after 3 and 6 months treatment than before(P<0.05).Meanwhile,in the parts of genital tract,anorectum and urinary was also significantly lower after treatment than before treatment(P<0.05).However,the score of PFIQ-7 was not significant difference between three months pessary treatment and six months pessary treatment.Conclusion: Using pessary treatment can effectively improve the disturbance of urination and the symptoms of vagina or pelvic in elderly POP patients,and significantly improve the quality of life of the patients.The success of pessary placement is not associated with age,body mass index,number of menopausal years,incorporate diabetes mellitus or not,the history of pregnancy and the degree of pelvic organ prolapse.Pelvic floor function of POP patients was restored after treatment with pessary,but there was no significant improvement in the anatomy repairment of pelvic floor in the short and medium term.