Mutone Martina F, Terry Colin, Hale Douglass S, Benson J Thomas
Indiana University and Methodist Hospital, Indianapolis, IN, USA.
Am J Obstet Gynecol. 2005 Jul;193(1):89-94. doi: 10.1016/j.ajog.2004.12.012.
The purpose of this study was to identify patient criteria which may affect the outcome of a pessary trial.
Records of 407 patients presenting with symptomatic pelvic organ prolapse who had a trial of pessary management were reviewed. Success was defined both by the initial fitting as well as by whether the patient was using the pessary at the 3-week follow-up visit. Outcomes were compared using chi-square test, 2-sample Student t test, or the Wilcoxon rank sum test, as appropriate. Statistical analysis was carried out at a significance of .05.
One hundred sixty-eight patients (41%) were successfully fitted and continuing to use a pessary at the time of the 3-week follow-up visit. The likelihood of a successful pessary trial was significantly lower in subjects with a past history of hysterectomy (P<.001) or known reconstructive surgery for prolapse (P=.010). There was no association between the stage of prolapse and pessary trial outcome. There was no significance found in the relationship between the predominant location of support loss and the pessary trial outcome at the 3-week follow-up visit.
The type and severity of pelvic organ prolapse do not influence the likelihood of a successful pessary fitting, and should not be used as a basis on which to select patients for pessary management.
本研究旨在确定可能影响子宫托试用结果的患者标准。
回顾了407例有症状盆腔器官脱垂且接受子宫托治疗试验患者的记录。成功的定义既包括初次适配，也包括患者在3周随访时是否仍在使用子宫托。根据情况，使用卡方检验、双样本学生t检验或威尔科克森秩和检验对结果进行比较。统计分析的显著性水平为0.05。
168例患者（41%）在3周随访时成功适配并继续使用子宫托。既往有子宫切除史（P<0.001）或已知有脱垂重建手术史（P=0.010）的患者成功进行子宫托试验的可能性显著降低。脱垂程度与子宫托试验结果之间无关联。在3周随访时，主要支撑缺失部位与子宫托试验结果之间的关系无显著性差异。
盆腔器官脱垂的类型和严重程度不影响子宫托适配成功的可能性，不应作为选择子宫托治疗患者的依据。
