Methods: Women with POP who attended the outpatient clinic for pessary cleaning between January and October 2021 were included. Primary outcome was pain during removal and reinsertion of the pessary, measured by an 11-point numeric rating scale (NRS). Secondary outcome was vaginal discharge, measured by the NRS and Patient Global Impression of Change scale (PGI-C). Multiple linear regression analysis was used to identify associated variables for pain and discharge.
Results: A total of 150 women were included. Mean NRS during pessary removal was 4.3 (± 2.7), with 25% of women scoring a 7 or higher. Mean NRS during reinsertion was 1.8 (± 2.0). A smaller genital hiatus and presence of vaginal atrophy or vulvar skin disease were associated with pain during pessary removal. Mean NRS for vaginal discharge was 2.5 (± 2.3). Twenty-five percent of women reported that their vaginal discharge was “(very) much worse” than before they used a pessary. Presence of vaginal erosions was associated with vaginal discharge in this study population.
Conclusions: Removing a pessary in an outpatient setting is a painful procedure for many women who use a pessary continuously. Moreover, 25% of these women experience an increase in vaginal discharge while using a pessary. Future research should focus on reducing these disadvantages.
Lara M. Kruyt,1 J. Marinus van der Ploeg,1 Karin Lammers,2 Britt A. van Etten-Debruijn,1 Anuschka S. Niemeijer3 & Robert A. Hakvoort1
- Department Obstetrics & Gynecology, Martini Hospital, PO Box 30033, 9700 RM, Groningen, The Netherlands
- Department Obstetrics & Gynecology, Ommelander Hospital, Scheemda, The Netherlands
- Scientific Institute, Martini Hospital, Groningen, The Netherlands
Source: Kruyt, L.M., van der Ploeg, J.M., Lammers, K. et al. Pessaries for pelvic organ prolapse: evaluation of vaginal discharge and pain during pessary cleaning in an outpatient setting. Int Urogynecol J 35, 333–339 (2024). https://doi.org/10.1007/s00192-023-05648-5