[Safety and acceptance of self application of cubic pessaries and urethral ring pessaries]

Abstract

Objective: Flexible cubic and ring pessaries with a suburethral thickening are devices for the treatment of genital prolapse and urinary stress incontinence. Threads attached to the pessary enable overnight self-removal and self-application. Little is known about the safety and women's acceptance of these devices.

Methods: Eighteen women (age 36-85 years), 9 of them with failed surgery, tried this therapy (cubic pessary n = 6; ring pessary n = 12). The size of the pessary was chosen clinically. All patients were seen after a week and then monthly.

Results: All women showed up after 1 week. Twelve of 18 women felt comfortable with these devices at that time. During follow-up, 5/18 women wanted surgical therapy within the first 2 months, 3/18 refused the device later, 1/18 was lost to follow-up and 9/18 patients continued pessary therapy for a mean duration of 11 months. During 107 treatment months, only 2 mild complications were observed without the need to intervention (mild vaginal erosion, spotting).

Conclusions: Pessary therapy is safe but has a dropout rate of approximately 50%. It can be an efficient alternative method in motivated women.