Delayed vesicovaginal fistula after ring
pessary usage.
(3) Sixty percent of patients who completed the study (the dropout rate was 37%) reported symptom relief with both types of
pessary. Outcomes were measured by multiple questionnaires and Likert scales.
In our study we had 8 out of 94 patients who had conservative treatment in the form of
pessary and the rest were treated surgically.
Patients for whom pessaries are the most suitable form of treatment are managed in a dedicated
pessary clinic.
The women completed the 12-item Intimate Relationship Scale (IRS) before
pessary placement and again at 6-12 months after placement.
Subjects could discontinue the use of either
pessary at any time.
In this situation, a
pessary that has both an incontinence knob and a support rim to help prevent pelvic cavity organs from sagging into the vagina can help alleviate incontinence and pelvic organ prolapse problems.
Transvaginal placement of a silicone
pessary around the cervix "is thought to support the cervix and change its direction toward the sacrum, thereby reducing the direct pressure from the uterine contents on the cervical canal." However, two recent randomized trials of this treatment produced contradictory results, with one showing the device reducing the rate of spontaneous preterm delivery and the other showing it had no effect, reported Dr.
Major complications associated with neglected ring pessaries, such as fistulas (vesicovaginal, rectovaginal), vaginal vault perforation,
pessary incarceration, urosepsis and
pessary entrapment/ embedment, are well noted in the literature.
Among those who received the
pessary, the odds ratio (OR) for PTB before 34 weeks was significantly reduced (OR, 0.18; 95% confidence interval [CI], 0.08-0.37), and the OR for adverse composite neonatal outcome also was significantly reduced (OR, 0.14; 95% CI, 0.04-0.39).
Non-surgical options include pelvic floor muscle training (PFMT), local and systemic estrogens and
pessary placement.
Nor the patient or her attendants were able to recall the event when
pessary was applied on her.