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Multicenter Study
. 2023 Aug;308(2):651-659.
doi: 10.1007/s00404-023-07075-9. Epub 2023 May 21.

Evaluating compliance and applicability of postpartum pessary use for preventing and treating pelvic floor dysfunction: a prospective multicenter study

Brenda Kiefner  1 , Frank Schwab  2 , Madeleine Kuppinger  1 , Anna Nacke  3 , Ute Kelkenberg  4 , Sabine Schütze  1 , Franziska Berger  1 , Anna Lindner  1 , Lars Hellmeyer  3 , Wolfgang Janni  1 , Melanie Metz #  3 , Miriam Deniz #  5
Affiliations
Multicenter Study

Evaluating compliance and applicability of postpartum pessary use for preventing and treating pelvic floor dysfunction: a prospective multicenter study

Brenda Kiefner et al. Arch Gynecol Obstet. 2023 Aug.

Abstract

Purpose: Pelvic floor disorders are common and associated with pregnancy and childbirth. For restitution of pelvic floor connective tissue and thereby therapy of postpartum pelvic organ prolapse and stress urinary incontinence, the Restifem® pessary is approved. It supports the anterior vaginal wall behind the symphysis, the lateral sulci and the sacro-uterine ligaments and stabilises the connective tissue. We evaluated the compliance and applicability of Restifem® use in women postpartum in a preventive and therapeutic approach.

Methods: Restifem® pessary was handed out to 857 women. Six weeks after birth, they started the pessary use. After 8 weeks, 3 and 6 months postpartum, women received a questionnaire via online survey for evaluation of pessary applicability and efficacy.

Results: After 8 weeks, 209 women answered the questionnaire. 119 women used the pessary. Common problems were discomfort, pain and the pessary use was to circuitous. Vaginal infections were rare. After 3 months, 85 women and after 6 months, 38 women still used the pessary. 3 months postpartum, 94% of women with POP, 72% of women with UI and 66% of women with OAB stated to have an improvement of their symptoms using the pessary. 88% women without any disorder felt an improvement of stability.

Conclusions: Use of the Restifem® pessary in the postpartum period is feasible and accompanied with less complications. It reduces POP and UI and leads to an increased sense of stability. So, Restifem® pessary can be offered to women postpartum to improve pelvic floor dysfunction.

Keywords: Compliance; Pelvic floor dysfunction; Pessary therapy; Postpartum; Prevention.

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Conflict of interest statement

None of the authors have any conflicts of interest regarding this work.

Figures

Fig. 1
Fig. 1
The Restifem pessary© in size M and S
Fig. 2
Fig. 2
A Time table of the study flow and return rate of evaluable questionnaires. B Percentage of women using the pessary, using the pessary daily and not using the pessary over time
Fig. 3
Fig. 3
Percentage of improvement, deterioration and unchanged symptoms in women with bladder dysfunction, bowl dysfunction, pelvic organ prolapse or sexual dysfunction at the three time points
Fig. 4
Fig. 4
A Overall satisfaction with pessary use at the three time points on a scale from (not at all satisfied) – 100 (extremely satisfied). B Percentage of women feeling an improvement of pelvic floor stability at the three time points
See this image and copyright information in PMC

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