Manchana Tarinee, Bunyavejchevin Suvit
Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Int Urogynecol J. 2012 Jul;23(7):873-7. doi: 10.1007/s00192-011-1634-6. Epub 2012 Jan 6.
The purpose of this study was to evaluate symptoms associated with pelvic organ prolapse (POP) and quality of life (QOL) improvement in patients who continue ring pessary use at 1 year.
Seventy-seven symptomatic POP patients had successful fitting, and 64 patients (83.1%) continued use at 1 year. The Thai version of Prolapse Quality of Life (P-QOL) questionnaire was used to evaluate symptoms associated with POP and impact on QOL. A higher score represents a greater impairment on the QOL, whereas a lower score represents a better QOL.
Mean age was 66.7 ± 8.6 years, median parity was 4 (range 0-10), 59 patients (92.2%) were menopausal, and none had received hormone treatment. Only nine patients (14.1%) were sexually active. Most patients were in the advanced stage of POP - 32.8% stage 3 and 29.7% stage 4. Improvement of prolapse symptoms and voiding difficulty were reported in 100% and 85.7% of the patients, respectively. Among patients who had lower urinary tract symptoms at pre-treatment, about half of patients improvement in frequency, urgency, and urgency urinary incontinence. Only 9.1% of the patients had improvement in stress urinary incontinence (SUI), and 23.8% of the patients reported new onset of SUI (de novo SUI). The median score from all P-QOL domains except personal relationships were significantly decreased after 1 year of ring pessary use. The median total scores at baseline and at 1 year were 40 and 8, respectively (P < 0.001).
Ring pessary is an effective non-surgical treatment to alleviate symptoms associated with POP. It can improve QOL in symptomatic POP patients.
本研究旨在评估在持续使用子宫托一年的患者中，与盆腔器官脱垂（POP）相关的症状及生活质量（QOL）的改善情况。
77例有症状的POP患者成功适配子宫托，64例患者（83.1%）持续使用一年。采用泰国版子宫脱垂生活质量（P-QOL）问卷评估与POP相关的症状及对生活质量的影响。分数越高表示生活质量受损越严重，分数越低表示生活质量越好。
平均年龄为66.7±8.6岁，中位产次为4次（范围0 - 10次），59例患者（92.2%）处于绝经状态，且均未接受激素治疗。只有9例患者（14.1%）有性生活。大多数患者处于POP晚期——32.8%为3期，29.7%为4期。分别有100%和85.7%的患者报告脱垂症状和排尿困难有所改善。在治疗前有下尿路症状的患者中，约一半患者的尿频、尿急和急迫性尿失禁症状有所改善。只有9.1%的患者压力性尿失禁（SUI）有所改善，23.8%的患者报告出现新发SUI（原发性SUI）。使用子宫托一年后，除人际关系外，所有P-QOL领域的中位得分均显著降低。基线时和一年时的中位总分分别为40分和8分（P < 0.001）。
子宫托是缓解与POP相关症状的一种有效的非手术治疗方法。它可以改善有症状的POP患者的生活质量。
