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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 ...
Source: HighBeam Research, Age, comorbidity predict use of pessaries beyond 1 year: pelvic organ...