Markle Danielle, Skoczylas Laura, Goldsmith Crystal, Noblett Karen
From the *University of California, Irvine, CA; †Magee-Women's Hospital, University of Pittsburgh, Pittsburgh, PA; and ‡Oregon Health Sciences University Portland, OR.
Female Pelvic Med Reconstr Surg. 2011 Sep;17(5):249-52. doi: 10.1097/SPV.0b013e31822f00ae.
: The objective of the study was to assess if patient characteristics, including Pelvic Organ Prolapse Quantification measurements, are predictive of successful pessary fitting in women with pelvic organ prolapse (POP) and/or incontinence.
: This was a retrospective chart review of patients who underwent a pessary fitting for POP and/or incontinence. Multiple demographic parameters, pessary fitting data, and Pelvic Organ Prolapse Quantification measurements were examined.
: Complete data were available on 158 patients, and 59% were successfully fit. Shorter total vaginal length (TVL), less than 8 cm, was associated with an unsuccessful pessary fitting (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.02-0.46). A genital hiatus (GH)/TVL ratio of less than 0.9 was predictive of successful fitting (OR, 12.5; 95% CI, 1.5-102). Patients with a prior hysterectomy were more likely to have an unsuccessful pessary fitting (OR, 0.41; 95% CI, 0.22-0.8). The GH/TVL ratio and TVL were predictors only in patients with a previous hysterectomy.
: Patients with a previous hysterectomy and a TVL of less than 8 cm or a GH/TVL ratio of 0.9 or greater can be counseled that successful pessary fitting is unlikely.
本研究的目的是评估患者特征，包括盆腔器官脱垂量化测量值，是否可预测盆腔器官脱垂（POP）和/或尿失禁女性子宫托适配成功。
这是一项对因POP和/或尿失禁接受子宫托适配的患者的回顾性病历审查。检查了多个人口统计学参数、子宫托适配数据和盆腔器官脱垂量化测量值。
158例患者有完整数据，59%适配成功。总阴道长度（TVL）较短，小于8cm，与子宫托适配不成功相关（比值比[OR]，0.1；95%置信区间[CI]，0.02 - 0.46）。生殖裂孔（GH）/TVL比值小于0.9可预测适配成功（OR，12.5；95%CI，1.5 - 102）。既往有子宫切除术的患者子宫托适配不成功的可能性更大（OR，0.41；95%CI，0.22 - 0.8）。GH/TVL比值和TVL仅在既往有子宫切除术的患者中为预测因素。
对于既往有子宫切除术且TVL小于8cm或GH/TVL比值为0.9或更高的患者，可以告知其子宫托适配成功的可能性不大。
