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Age, comorbidity predict use of pessaries beyond 1 year: pelvic organ prolapse.(Gynecology)

OB GYN News

| December 01, 2003 | McNamara, Damian | COPYRIGHT 2003 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

HOLLYWOOD, FLA. -- Age greater than 65 years and severe comorbidity were significant predictors of continued pessary use after 1 year for women with pelvic organ prolapse, according to a study presented at the annual meeting of the American Urogynecologic Society.

"Age was such a strong predictor of continued pessary use," Dr. Jeffrey L. Clemons said. Use of age over 65 as a clinical cutoff had 95% sensitivity and 63% specificity to predict whether women would continue pessary use or opt for pelvic reconstruction surgery. The positive predictive value was 87%; the negative predictive value was 83%.

To identify factors associated with continued pessary use, Dr. Clemons and his colleagues recruited 100 women with at least stage 2 prolapse for a prospective, observational study between March 2001 and August 2003. The mean age was 71 years, 49% had a prior hysterectomy, and 42% had prior pelvic reconstructive surgery. A total of 40% said they were sexually active, said Dr. Clemons of the Madigan Army Medical Center in Tacoma, Wash.

At 2 months, 67 of the women were satisfied with their pessary use and agreed to be reassessed at 1 year. One of the women died, rive were lost to follow-up, and two discontinued use of their pessary and chose not to have surgery. The 59 women remaining at 1 year were divided into two groups--those who continued use (43 women) and those who discontinued and had pelvic ...

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