ArticleInternational urogynecology journal2017
Is hysterectomy or prior reconstructive surgery associated with unsuccessful initial trial of pessary fitting in women with symptomatic pelvic organ prolapse?
Article in International urogynecology journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Parameters associated with unsuccessful pessary fitting for pelvic organ prolapse up to three months follow-up: a systematic review and meta-analysis.International urogynecology journal · 2022Pooled it
- Pessary Uptake and Outcomes in Women Who Ultimately Had Surgery for Prolapse.International urogynecology journal · 2026Article
- International Urogynecology Consultation Chapter 3 Committee 1 - Pessary Management.International urogynecology journal · 2025Review
- Adherence to support pessary in the treatment of pelvic organ prolapse: a retrospective study conducted among 1,371 women.International urogynecology journal · 2024Article
- Outcomes of pessary fitting trials for patients with stage IV pelvic organ prolapse: a prospective study.International urogynecology journal · 2024Article
- Transition to surgery after pessary among female Medicare beneficiaries with pelvic organ prolapse.American journal of obstetrics and gynecology · 2023Article
- Self-management of vaginal cube pessaries may be a game changer for pelvic organ prolapse treatment: a long-term follow-up study.International urogynecology journal · 2023Article
- First-line treatment of pelvic organ prolapse and discontinuation of pessary treatment.International urogynecology journal · 2020Article
- Managing female pelvic floor disorders: a medical device review and appraisal.Interface focus · 2019Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisThere is little data in the literature regarding the feasibility and limitations of pessary therapy after pelvic reconstructive surgery for symptom recurrence for treating urinary incontinence. Hysterectomy is an important risk factor for failure of pessary fitting. We aimed to evaluate the influence of these prior surgeries on subsequent initial trials of fitting a pessary.
methodsSix hundred and twenty-nine women with symptomatic pelvic organ prolapse (POP) were included in a prospective cohort study from January 2014 to December 2015. All women had symptomatic stage ≥2 POP. During the study period, various types of pessaries were used for the fitting process.
resultsO the 629 women, 489 (77.7 %) had neither hysterectomy nor reconstructive pelvic surgery, and 24 (3.8 %) had hysterectomy for different indications. Initial pessary fitting was possible in all patients in both groups (100 %) 116 (18.4 %) had a total of 159 previous, predominantly vaginal, surgeries for POP, with or without vaginal hysterectomy. In 25/116 (21.5 %) cases, initial fitting was impossible due to altered anatomy. After one surgery, the probability of failure was 18.8 % (15/80) and after two 27.3 % (9/33). Of the three women who had three or more surgeries, one failure occurred.
conclusionSurgery for POP is an important risk factor for an unsuccessful pessary fitting. It seems conclusive to recommend pessary treatment as a general first-line therapy for symptomatic POP, since after unsuccessful pessary treatment, women can still undergo surgery, whereas reversing treatment options might not always be feasible.
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