ReviewCanadian Urological Association journal = Journal de l'Association des urologues du Canada
An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse.
Review in Canadian Urological Association journal = Journal de l'Association des urologues du Canada. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Fistulae Secondary to Vaginal Pessary Use for Pelvic Organ Prolapse: A Systematic Review.International urogynecology journal · 2025Pooled it
- Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies.The Cochrane database of systematic reviews · 2020Pooled it
- Clinical and cost-effectiveness of pessary self-management versus clinic-based care for pelvic organ prolapse in women: the TOPSY RCT with process evaluation.Health technology assessment (Winchester, England) · 2024Trial
- Vaginal microflora following the use of a disposable home-use vaginal device and a commercially available ring pessary for pelvic organ prolapse management: a randomized controlled trial.Archives of gynecology and obstetrics · 2024Trial
- ESTROgen use for complications in women treating pelvic organ prolapse with vaginal PESSaries (ESTRO-PESS)-a randomized clinical trial.International urogynecology journal · 2021Trial
- The extended pessary interval for care (EPIC) study: a failed randomized clinical trial.International urogynecology journal · 2021Trial
- Effects of Delayed Pessary Maintenance Appointments on Patient's Symptoms and Clinical Findings During the COVID-19 Pandemic.International urogynecology journal · 2026Article
- Demographic, socioeconomic and functional health-related factors in the selection of vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a retrospective study.BMC women's health · 2025Article
- International Urogynecology Consultation Chapter 3 Committee 1 - Pessary Management.International urogynecology journal · 2025Review
- A New Application for Bolt Cutters in Urogynecology: Challenging Removal of an Impacted Pessary.HCA healthcare journal of medicine · 2025Article
- Effectiveness and safety of a novel, collapsible pessary for management of pelvic organ prolapse.American journal of obstetrics and gynecology · 2024Article
- Evaluation of Neuromuscular Morphometry of the Vaginal Wall Using Protein Gene Product 9.5 (Pgp 9.5) and Smooth Muscle α-Actin (Sma) in Patients with Posterior Vaginal Wall Prolapse.Medicina (Kaunas, Lithuania) · 2024Article
- Vaginal pessary: a culprit for intraperitoneal bladder perforation.BMJ case reports · 2024Article
- Pessary-related complications: a brief overview.Gynecology and pelvic medicine · 2024Article
- Diagnostic Value of Dynamic Magnetic Resonance Imaging (dMRI) of the Pelvic Floor in Genital Prolapses.Biomedicines · 2023Review
- Pessary management practices for pelvic organ prolapse among Australian health care practitioners: a cross-sectional study.International urogynecology journal · 2023Article
- Adverse events associated with pessary use over one year among women attending a pessary care clinic.International urogynecology journal · 2023Observational
- Complications of Pessaries Amenable to Surgical Correction: Two Case Reports and a Systematic Review of the Literature.Journal of personalized medicine · 2023Review
- The impact on complication rates of delayed routine pessary reviews during the COVID-19 pandemic.International urogynecology journal · 2023Article
- Common Medical Devices with Uncommon Complications.Journal of obstetrics and gynaecology of India · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPessary use is the preferred non-surgical treatment option for female pelvic organ prolapse. As pessaries can be used chronically to alter pelvic floor anatomy, consideration of short-and long-term complications is important in patient management. We systematically reviewed articles describing the complications of pessary use to determine frequency and severity.
methodsA systematic search via MEDLINE and PubMed using the key terms "complications," "pessary," "pelvic organ prolapse," "side effects" was conducted for the years 1952 to 2014 inclusively. Selected articles cited in the publications identified were also considered. Only full-text material published in English was reviewed. All pessary-related complications described were collated; overall frequency within case reports and case series were calculated and severity was graded using the Clavien-Dindo classification.
resultsIn total, 61 articles met the inclusion criteria. The most common complications reported were vaginal discharge/vaginitis, erosion, and bleeding. Complications were related to pessary shape and material, and duration in situ. Clavien-Dindo classification of complication severity found that all 5 grade levels were attributed to pessary use; serious grade 4 and 5 complications included cancer, adjacent organ fistula and death.
conclusionThere are few detailed reports of complications of pessary use relative to the estimated frequency of pessary use worldwide. Prospective studies documenting complications by shape, material, and size, and objectively classifying complication severity are required. As serious grade 4 and 5 complications of pessary use occur, further development of clinical follow-up guidelines for long-term pessary users is justified.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.