Observational studyBJOG : an international journal of obstetrics and gynaecology2026
The Effect of Pessary Insertion on Pelvic Anatomy: A Prospective Observational Study Using Upright MRI.
Observational study in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine the anatomical effect of pessaries in the upright position in women with pelvic organ prolapse (POP).
designProspective observational cohort study.
settingOutpatient clinic of our gynaecology department. POPULATION: Fifteen POP patients with successful ring-shaped pessary use.
methodsUpright magnetic resonance (MR) images of the pelvis were acquired before, immediately after insertion of their pessaries, and 1 week later.
main outcome measuresDistances from the lowest points of the bladder, cervix, and pessary to the pelvic inclination correction system (PICS) line were measured, as well as the angles of the uterus and pessary relative to the PICS in the midsagittal plane.
resultsPessary insertion lifted the bladder's lowest point from 0.1 cm below to 0.6 cm above the PICS (p = 0.015), but it descended to 0.2 cm above the PICS 1 week later (p = 0.334). The cervix was lifted from 0.0 to 2.5 cm above the PICS (p < 0.001), which persisted after 1 week (p = 0.470). The angle between uterus and PICS increased after insertion from 97
conclusionPessary insertion changes the pelvic organ position and angulation. After an initial lift, the effect on the bladder diminished after 1 week, while for the uterus it remained. This may suggest a role for uterus lift in relieving POP symptoms.
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