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Case Reports
. 2013 Aug;122(2 Pt 2):446-449.
doi: 10.1097/AOG.0b013e31828aec98.

Nonsurgical management of a rectovaginal fistula caused by a Gellhorn pessary

Sara Cichowski  1 , Rebecca G Rogers
Affiliations
Case Reports

Nonsurgical management of a rectovaginal fistula caused by a Gellhorn pessary

Sara Cichowski et al. Obstet Gynecol. 2013 Aug.

Abstract

Background: Pessaries are generally thought to be a safe, well-tolerated treatment for pelvic organ prolapse.

Case: An 85-year-old woman had a Gellhorn pessary placed for pelvic organ prolapse. Although she was seen regularly for care, the pessary had not been removed for several years. She presented stating that she felt the pessary had shifted. On examination, the patient's pessary stem had eroded through the vagina into the rectum. The pessary was removed and the patient was treated with vaginal estradiol cream. One month later the fistula tract had resolved and the patient continued to desire a pessary to manage her pelvic organ prolapse.

Conclusion: Pessaries require care and maintenance. Patients' desires for conservative management should be coupled with education and routine follow-up.

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References

    1. Lamers BH, Broekman BM, Milani AL. Pessary treatment for pelvic organ prolapse and health-related quality of life: a review. Int Urogynecol J 2011;22:637–44.
    1. Cundiff GW, Weidner AC, Visco AG, Bump RC, Addison WA. A survey of pessary use by members of the American Urogynecologic Society. Obstet Gynecol 2000;95:931–5.
    1. Yong PJ, Garrey MM, Geoffrion R. Transvaginal repair and graft interposition for rectovaginal fistula due to a neglected pessary: case report and review of the literature. Female Pelvic Med Reconstr Surg 2011;17:195–7.
    1. Powers K, Grigorescu B, Lazarou G, Greston WM, Weber T. Neglected pessary causing a rectovaginal fistula: a case report. J Reprod Med 2008;53:235–7.
    1. Tarr M, Culbertson S, Lengyel E. Transverse transperineal repair of a pessary-induced mid-rectovaginal fistula. J Pelvic Med Surg 2008;14:199–201.

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