Incontinence Research Today is a free monthly online journal that collates and summarizes the latest research about Incontinence, including details on urinary incontinence, bladder control, treatment, causes.

Pelvic floor symptom changes in pessary users.

Komesu YM, Rogers RG, Rode MA, Craig EC, Gallegos KA, Montoya AR, Swartz CD

Division of Urogynecology and Pelvic Floor Disorders, Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center School of Medicine, Albuquerque, NM, USA.

OBJECTIVE: The objective of the study was to compare pelvic floor symptom changes in patients who continue vs discontinue pessary use, and determine whether changes predict pessary continuation. STUDY DESIGN: Women fitted with pessaries completed the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary use. Scores were compared in women who continued vs discontinued pessaries. Analysis of covariance adjusted for baseline differences in scores. Logistic regression and receiver operating characteristic curves were used to find a score predicting pessary continuation. RESULTS: Sixty-four women had complete follow up data; at 6-12 months, 36 of 64 (56%) continued pessary use, and 28 of 64 (44%) discontinued use. The continuation group's final PFDI-20 total, bladder, and prolapse scale scores were better than the discontinuation group's. A 2-month prolapse score that fell to 50% of baseline best predicted pessary continuation. CONCLUSION: PFDI-20 scores improved most in women continuing pessary use. Pessaries effectively treated urinary symptoms, and most effectively treated prolapse symptoms. Prolapse score improvement best predicted continued pessary use.

Published 6 December 2007 in Am J Obstet Gynecol, 197(6): 620.e1-6.
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