Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
BJOG. 2018 Oct;125(11):1434-1440. doi: 10.1111/1471-0528.15260. Epub 2018 May 29.
To evaluate the success rate of vaginal pessary fitting and identify the risk factors associated with unsuccessful pessary fitting in a large cohort of patients with symptomatic pelvic organ prolapse (POP).
Prospective observational study.
The Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Beijing, China.
Women with symptomatic POP between May 2015 and December 2016 (n = 343).
A successful pessary fitting was defined as a patient fitted with a pessary at the initial fitting and continued use 2 weeks later. The independent samples t-test, non-parametric test, Chi-square test, Fisher's exact test, logistic regression and receiver operating characteristic curves were used for the data analysis.
The success rate of vaginal pessary fitting and the risk factors associated with unsuccessful pessary fitting.
302 patients had successful pessary fitting (88.0% success rate). A higher body mass index [BMI; 24.7 ± 3.1 kg/m in the successful group versus 25.7 ± 3.8 kg/m in the unsuccessful group, odds ratio (OR) 1.174, 95% CI 1.055-1.307, P = 0.003] and a shorter TVL [8.0 (8-9) cm in the successful group versus 7.0 (6.8-8) cm in the unsuccessful group, OR 0.338, 95% CI 0.223-0.513, P < 0.001) were independent predictors of an unsuccessful pessary fitting. The receiver operating characteristic curve showed that patients with a total vaginal length (TVL) less than 7.3 cm had a higher unsuccessful pessary fitting rate (sensitivity = 0.82, specificity = 0.64).
A higher BMI and shorter TVL were independent predictors of an unsuccessful pessary fitting. Patients with a TVL <7.3 cm are not appropriate candidates for a vaginal pessary.
A higher BMI and shorter TVL (<7.3 cm) were independent predictors of an unsuccessful pessary fitting.
评估阴道子宫托适配的成功率，并确定与症状性盆腔器官脱垂（POP）患者阴道子宫托适配失败相关的风险因素。
前瞻性观察性研究。
中国北京，北京协和医学院医院妇产科。
2015 年 5 月至 2016 年 12 月间患有症状性 POP 的女性（n=343）。
将初始适配时成功佩戴子宫托且 2 周后继续使用的患者定义为适配成功。采用独立样本 t 检验、非参数检验、卡方检验、Fisher 确切检验、逻辑回归和受试者工作特征曲线进行数据分析。
阴道子宫托适配的成功率以及与适配失败相关的风险因素。
302 例患者阴道子宫托适配成功（成功率为 88.0%）。较高的体质指数（BMI）[24.7±3.1kg/m2 成功组 vs. 25.7±3.8kg/m2 失败组，优势比（OR）1.174，95%置信区间（CI）1.055-1.307，P=0.003]和较短的总阴道长度（TVL）[8.0（8-9）cm 成功组 vs. 7.0（6.8-8）cm 失败组，OR 0.338，95%CI 0.223-0.513，P<0.001]是阴道子宫托适配失败的独立预测因素。受试者工作特征曲线显示，TVL 小于 7.3cm 的患者阴道子宫托适配失败率更高（灵敏度=0.82，特异性=0.64）。
较高的 BMI 和较短的 TVL 是阴道子宫托适配失败的独立预测因素。TVL<7.3cm 的患者不适合阴道子宫托。
较高的 BMI 和较短的 TVL（<7.3cm）是阴道子宫托适配失败的独立预测因素。
