Symptomatic and anatomic improvement of pelvic organ prolapse in vaginal pessary users

Int Urogynecol J. 2021 Apr;32(4):1023-1029. doi: 10.1007/s00192-020-04540-w. Epub 2020 Oct 13.


Introduction and hypothesis: The vaginal pessary is a conservative method for treating pelvic organ prolapse (POP). It is able to reduce symptoms with minimal complications, improving quality of life (QOL). This study's hypothesis was that the use of pessaries decreases quantitative measures and improves women's QOL. We aimed to evaluate the effects of the use of a ring pessary on the quantitative measurements of POP by the Pelvic Organ Prolapse Quantification (POP-Q) and on QOL.

Methods: Prospective cohort study divided in two stages. In stage I POP-Q and QOL were assessed prior to the use of the ring pessary and in stage II after its use for at least 4 months with pessary removal 72 h before clinical evaluation. Wilcoxon tests were performed for necessary comparisons and Spearman's tests for calculating correlations.

Results: One hundred thirty-six women were evaluated, of which 50 were included. There was a decrease in POP in at least one of the vaginal compartments in the women included. When assessing individual measures (Ba, Bp and C), reductions in all measures were observed. There was also an improvement in the general and specific quality of life of women.

Conclusion: The ring pessary proved to be a good therapeutic option, with a reduction in POP-Q measurements and/or absence of POP progression in the short term and an improvement in women's QOL.

Keywords: Conservative treatment; Pelvic organs prolapse; Pessary; Vaginal prolapse.

MeSH terms

  • Female
  • Humans
  • Pelvic Organ Prolapse* / therapy
  • Pessaries*
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome
  • Vagina