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The Impact of Pessary Use on Bowel Symptoms: One-Year Outcomes

Brazell, Hema D. MD*; Patel, Minita MD; O’Sullivan, David M. PhD; Mellen, Colleen APRN*; LaSala, Christine A. MD*

Female Pelvic Medicine & Reconstructive Surgery: March/April 2014 - Volume 20 - Issue 2 - p 95–98
doi: 10.1097/SPV.0000000000000060
Original Articles

Objectives: The literature states that patients with pelvic organ prolapse have a higher prevalence of bothersome bowel symptoms and that surgical correction of prolapse may improve bowel function. There is limited knowledge regarding the impact of pessary use on bowel function in patients with prolapse. The aim of this study was to evaluate if there is a change in bowel symptoms in patients with prolapse treated with a vaginal pessary.

Methods: Women who presented for pessary insertion completed the validated questionnaires on the bowel symptom severity and on the effect of bowel symptoms on the quality of life at baseline and again at 12 months of continuous pessary use. Inferential statistics comprised Student t test for evaluating differences in continuous Gaussian data between groups and paired t tests were used to evaluate differences among subjects between the baseline and 12 months of use.

Results: One hundred four women participated in the original study, and 43 had complete data for analysis. Women who completed 12 months of pessary use reported significant improvements in both bowel-related symptoms and bowel-related quality of life (95% confidence interval of the difference 1.6–11.4 and 2.0–14.0, respectively). Patients who completed the 12-month follow-up were significantly older and more likely to have stage 3 or 4 prolapse than noncompleters, but there were no differences in body mass index, race, history of prior prolapse surgery, or menopause status.

Conclusions: In women with prolapse, the use of a pessary is associated with a decrease in complaints related to bowel symptoms.

Among women with advanced prolapse, the use of a pessary may improve bowel symptoms.

From the *Division of Urogynecology, Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, CT; †Department of Obstetrics and Gynecology, Kaiser Permanente, Roseville, CA; and ‡Department of Research Administration, Hartford Hospital, Hartford, CT.

Reprints: Hema D. Brazell, MD, Division of Urogynecology, Department of Obstetrics and Gynecology, Hartford Hospital, 85 Seymour St, Suite 525, Hartford, CT 06106. E-mail: hbrazell@harthosp.org.

The authors have declared they have no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins