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Review| Volume 33, ISSUE 3, P59-67, March 2023

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Vaginal pessaries for the management of pelvic organ prolapse

Published:January 20, 2023DOI:https://doi.org/10.1016/j.ogrm.2023.01.001

      Abstract

      Pelvic organ prolapse (POP) is a common condition and is thought to affect approximately 40% of women over the age of 40, with prevalence increasing with age. Although POP is not usually associated with mortality, it can significantly impact quality of life. Management of POP includes, the option of no treatment, conservative and lifestyle management, pessary management or surgery. Options for management should take into consideration the woman's preference, the site of prolapse, lifestyle factors, comorbidities, age, desire for childbearing, previous surgery and whether the patient is sexually active. The risks and benefits of each option should be discussed, and women should be included in decision making. Vaginal pessaries are intravaginal devices that aim to restore prolapsed vaginal compartments to a normal position with aim to relieve symptoms. There are a wide variety of pessaries and these are usually made of plastic or silicone. The most commonly used pessaries in the UK are discussed in this article.

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      Further reading

        • Hagen S.
        • Stark D.
        • Glazener C.
        • et al.
        • POPPY Trial Collaborators
        Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial.
        Lancet. 2014; 383: 796-806
        • Haylen B.T.
        • Maher C.F.
        • Barber M.D.
        • et al.
        International urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for pelvic organ prolapse (POP).
        Int Urogynecol J. 2016; 27 (Erratum,2016, 27: 655-684; Neurourol Urodyn,2016,35:137-168): 165-194
        • Lone F.
        • Thakar R.
        • Sultan A.H.
        • Karamalis G.
        A 5-year prospective study of vaginal pessary use for pelvic organ prolapse.
        Int J Gynaecol Obstet. 2011; 114: 56-59
        • National Institute of Health and Care Excellence (NICE)
        Nice guideline 123: urinary incontinence and pelvic organ prolapse in women: management.
        2019
        • Pelvic Obstetric and Gynaecological Physiotherapists
        UK Clinical Guideline for best practice in the use of vaginal pessaries for pelvic organ prolapse.
        2021
        • UK Continence Society (UKCS)
        UK Clinical Guideline for best practice in the use of vaginal pessaries for pelvic organ prolapse.
        2021