Evidence map›Paper›PMID 37511669›Full record

ReviewJournal of personalized medicine2023

Complications of Pessaries Amenable to Surgical Correction: Two Case Reports and a Systematic Review of the Literature.

Laura Calles Sastre, Belén Almoguera Pérez-Cejuela, Augusto Pereira Sánchez, Sofía Herrero Gámiz, Javier F Magrina, Mar Ríos Vallejo, Tirso Pérez Medina

Open access · goldAbstract readReview
In one paragraph

Review in Journal of personalized medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Laura Calles SastreDepartment of Gynecologic Surgery, Puerta de Hierro University Hospital, Majadahonda, 28222 Madrid, Spain.ORCID 0000-0003-4073-2081
Belén Almoguera Pérez-CejuelaDepartment of Gynecologic Surgery, Puerta de Hierro University Hospital, Majadahonda, 28222 Madrid, Spain.ORCID 0000-0002-4735-0644
Augusto Pereira SánchezDepartment of Gynecologic Surgery, Puerta de Hierro University Hospital, Majadahonda, 28222 Madrid, Spain.ORCID 0000-0003-2534-1007
Sofía Herrero GámizDepartment of Gynecologic Surgery, Puerta de Hierro University Hospital, Majadahonda, 28222 Madrid, Spain.ORCID 0000-0002-3751-1205
Javier F MagrinaDepartment of Medical and Surgical Gynecology, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
Mar Ríos VallejoDepartment of Gynecologic Surgery, Puerta de Hierro University Hospital, Majadahonda, 28222 Madrid, Spain.
Tirso Pérez MedinaDepartment of Gynecologic Surgery, Puerta de Hierro University Hospital, Majadahonda, 28222 Madrid, Spain.ORCID 0000-0003-4560-453X
Hospital Universitario Puerta de Hierro Majadahonda · ESMayo Clinic Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundForty percent of women will experience prolapse in their lifetime. Vaginal pessaries are considered the first line of treatment in selected patients. Major complications of vaginal pessaries rarely occur.

methodsPubMed and Embase were searched from 1961 to 2022 for major complications of vaginal pessaries using Medical Subject Headings (MeSH) and free-text terms. The keywords were pessary or pessaries and: vaginal discharge, incontinence, entrapment, urinary infections, fistula, complications, and vaginal infection. The exclusion criteria were other languages than English, pregnancy, complications without a prior history of pessary placement, pessaries unregistered for clinical practice (herbal pessaries), or male patients. The extracted data included symptoms, findings upon examination, infection, type of complication, extragenital symptoms, and treatment.

resultsWe identified 1874 abstracts and full text articles; 54 were assessed for eligibility and 49 met the inclusion criteria. These 49 studies included data from 66 patients with pessary complications amenable to surgical correction. Clavien-Dindo classification was used to grade the complications. Most patients presented with vaginal symptoms such as bleeding, discharge, or ulceration. The most frequent complications were pessary incarceration and fistulas. Surgical treatment included removal of the pessary under local or general anesthesia, fistula repair, hysterectomy and vaginal repair, and the management of bleeding.

conclusionsPessaries are a reasonable and durable treatment for pelvic organ prolapse. Complications are rare. Routine follow-ups are necessary. The ideal patient candidate must be able to remove and reintroduce their pessary on a regular basis; if not, this must be performed by a healthcare worker at regular intervals.

Indexed as

cancercomplicationsfistulagenital prolapseincarcerationpessarysurgical complication

Identifiers

PMID37511669
PMCPMC10381278
OpenAlexW4382402130

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.