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Erschienen in:
08.07.2021 | COVID-19 | Clinical Opinion
Pessaries and rectovaginal fistulae: consequences of delayed clinical follow-up in the Covid-19 pandemic
Erschienen in: International Urogynecology Journal | Ausgabe 9/2021
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Introduction and hypothesis
While 2017 guidelines from The American College of Obstetricians & Gynecologists called for pessary replacement every 3 to 4 months, a recent study in Obstetrics and Gynecology suggested that uninterrupted pessary use up to 6 months is not an independent risk factor for development of pessary-related complications.
Methods
Our recent experience throughout the Covid-19 pandemic highlights the potential ramifications of delayed clinical follow-up.
Results
During the Covid-19 pandemic, 3 of our patients developed rectovaginal fistulae secondary to Gellhorn pessary erosion in the context of delayed clinical follow-up. Our patients had previously attended routine appointments every 3 months without complications until missed appointments secondary to the pandemic led to fistulae formation.
Conclusion
We believe that delayed clinical follow-up of pessary management beyond 3 months due to the Covid-19 pandemic may lead to fistula complications in elderly women with Gellhorn pessaries.