Supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the NIH Office of Research on Women's Health at National Institutes of Health (U10 HD54215, U10 HD41267, U10 HD41250, U10 HD41261, U10 HD54214, U10 HD54241, U10 HD54136, and U01 HD41249).
The aim of the study was to determine whether successful incontinence pessary fitting or pessary size can be predicted by specific POPQ measurements in women without advanced pelvic organ prolapse.
In a multicenter study, women with stress urinary incontinence (SUI) and POPQ stage ≤2 were randomized to three treatment arms: (1) incontinence pessary, (2) behavioral therapy, or (3) both. This study evaluates incontinence pessary size, POPQ measures, and successful fitting in the 266 women assigned to treatment arms 1 and 3.
Two hundred thirty-five women (92%) were successfully fitted with an incontinence ring (n = 122) or dish (n = 113). Hysterectomy, genital hiatus (GH), and GH/total vaginal length (TVL) ratios did not predict unsuccessful fitting (p > 0.05). However, mean TVL was greater in women successfully fitted (9.6 vs. 8.8 cm, p < 0.01). Final pessary diameter was not predicted by TVL, point D, or point C (p > 0.05).
The vast majority of women with SUI can be successfully fitted with an incontinence pessary, but specific POPQ measures were not helpful in determining incontinence pessary size.
Shah SM, Sultan AH, Thakar R (2006) The history and evolution of pessaries for pelvic organ prolapse. Int Urogynecol J 17:170–175 CrossRef
Nygaard I (1995) Prevention of exercise incontinence with mechanical devices. J Reprod Med 40:89–94 PubMed
Realini JP, Walters MD (1990) Vaginal diaphragm rings in the treatment of stress urinary incontinence. J Am Board Fam Pract 3:99–103 PubMed
Pott-Grinstein E, Newcomer JR (2001) Gynecologists' patterns of prescribing pessaries. J Reprod Med 46:205–208 PubMed
Cooper Surgical Product Catalog. Chapter on Milex Silicone Pessaries. 80973 Catalog QZ, Rev 1/06. Published by Cooper Surgical, Trumbull, CT. USA
Richter HE, Burgio KL, Goode PS, Borello-France D, Bradley CS, Brubaker L, Handa V, Kieback D, Visco AG, Zyczynski HM, Wei JT, Weber AM, for the Pelvic Floor Disorders Network (2007) Non-surgical management of stress urinary incontinence: ambulatory treatments for leakage associated with stress incontience (ATLAS) trial. Clin Trials 4:92–101 PubMedCrossRef
Nguyen JN, Jones CR (2005) Pessary treatment of pelvic relaxation. J Wound Ostomy Continence Nurs 32:255–261 PubMed
Maito JM, Quam ZA, Craig E, Danner KA, Rogers RG (2006) Predictors of successful pessary fitting and a continued use in a nurse-midwifery pessary clinic. J Midwifery Wom Health 51:78–84 CrossRef
Donnelly MJP-MS, Olsen AL, Nygaard IE (2004) Vaginal pessaries for the management of stress and mixed urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 15:302–307 PubMed
Farrell SA, Singh B, Aldakhil L (2004) Continence pessaries in the management of urinary incontinence in women. J Obstet Gynaecol Can 26:113–117 PubMed
Palumbo MV (2000) Pessary placement and management. Ostomy Wound Manage 46:40–45 PubMed
Cundiff GW AC, Bent AE, Coates KW, Schaffer JI, Strohbehn K, Handa VL (2007) The PESSRI Study: symptom relief outcomes of a randomized crossover trial of the ring and Gellhourn pessaries. Am J Obstet Gynecol 196:405.e401–405.e408
- Incontinence pessaries: size, POPQ measures, and successful fitting
Charles W. Nager
Holly E. Richter
Marie Fidela Paraiso
Jennifer M. Wu
Shanna D. Atnip
for the Pelvic Floor Disorders Network (PFDN)
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