Long-term Outcomes of Self-Management Gellhorn Pessary for Symptomatic Pelvic Organ Prolapse.

Abstract

OBJECTIVE:

The aim of this study is to estimate the long-term survival and to identify adverse events associated with the use of Gellhorn pessaries over a 9-year period.

METHODS:

This was a retrospective case series study at a tertiary urogynecology unit in Taiwan. Between January 2009 and June 2017, 93 patients who opted for self-management Gellhorn pessaries to treat symptomatic pelvic organ prolapse (POP) and who were continuously followed-up were enrolled. Long-term use was defined as use for longer than 1 year. Length of use, factors that predicted discontinuation, and adverse events were analyzed and reviewed by chart or telephone inquiry.

RESULTS:

The cumulative probabilities of continued pessary use at 1 and 5 years were 62.4% and 47.2%, respectively. Of those who discontinued use, 34 (70.8%) participants discontinued use within 1 year, and the mean duration of use was 13.7 months (range, 0-75 months; median, 5 months). Most of the participants stopped using the pessary because of bothersome adverse events such as pessary expulsion, vaginal pain, de novo urinary incontinence, and erosion/infection.

CONCLUSIONS:

Self-management Gellhorn pessary was safe and relatively effective and increased patients' autonomy and ability to manage their POP. One third of the patients discontinued use by 1 year, and half of the patients discontinued use at 5 years.

• Authors: Chih-Wei Chien, Tsia-Shu Lo, Ling-Hong Tseng, Yi-Hao Lin, Wu-Chiao Hsieh, Shu-Jane Lee
• Journal: Female pelvic medicine & reconstructive surgery (Female Pelvic Med Reconstr Surg) Vol. 26 Issue 11 Pg. e47-e53 (11 2020) ISSN: 2154-4212 [Electronic] United States
• PMID: 31393340 (Publication Type: Journal Article)

Topics

• Aged
• Female
• Humans
• Kaplan-Meier Estimate
• Middle Aged
• Pelvic Organ Prolapse (therapy)
• Pessaries (adverse effects, statistics & numerical data)
• Retrospective Studies
• Self-Management