Objective: : The objective of the study was to assess if patient characteristics, including Pelvic Organ Prolapse Quantification measurements, are predictive of successful pessary fitting in women with pelvic organ prolapse (POP) and/or incontinence.
Methods: : This was a retrospective chart review of patients who underwent a pessary fitting for POP and/or incontinence. Multiple demographic parameters, pessary fitting data, and Pelvic Organ Prolapse Quantification measurements were examined.
Results: : Complete data were available on 158 patients, and 59% were successfully fit. Shorter total vaginal length (TVL), less than 8 cm, was associated with an unsuccessful pessary fitting (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.02-0.46). A genital hiatus (GH)/TVL ratio of less than 0.9 was predictive of successful fitting (OR, 12.5; 95% CI, 1.5-102). Patients with a prior hysterectomy were more likely to have an unsuccessful pessary fitting (OR, 0.41; 95% CI, 0.22-0.8). The GH/TVL ratio and TVL were predictors only in patients with a previous hysterectomy.
Conclusions: : Patients with a previous hysterectomy and a TVL of less than 8 cm or a GH/TVL ratio of 0.9 or greater can be counseled that successful pessary fitting is unlikely.