Yang Junfang, Han Jinsong, Zhu Fuli, Wang Yu
Department of Obstetrics and Gynecology, Peking University Third Hospital, Garden North Road No. 49, Haidian District, Beijing, 100191, China.
Department of Obstetrics and Gynecology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China.
Arch Gynecol Obstet. 2018 Sep;298(3):623-629. doi: 10.1007/s00404-018-4844-z. Epub 2018 Jul 5.
The aim of this study was to identify factors associated with pessary fitting, continued use of pessary and satisfaction of patients with pelvic organ prolapse.
A retrospective study was conducted in patients who received an initial pessary fitting. The clinical characteristics of these patients were recorded. The Pelvic Floor Disability Index PFDI-20 and PFIQ-7 were used to assess pelvic floor dysfunction and quality of life. Complications, satisfaction degree, and reasons for abandonment were recorded during the follow-up. T test and Chi square test in SPSS version 20 were used to analyze the data.
Three hundred women with symptomatic prolapse were selected for pessary fitting, whose average age was 67.8 ± 10.7 years. For two hundred and forty-nine (83%) women, the fitting was successful, of whom 162 used ring pessaries and 87 used Gellhorn pessaries. Forty-seven patients abandoned using a pessary at the end of our study. Most clinical characteristics were not significantly different between the successful and unsuccessful fitting groups (P > 0.05). The average score of CRADI-8 was lower in successful fitting group (11.9 ± 15.9) than that in unsuccessful fitting group (18.8 ± 19.9) (P < 0.05). 162 patients with successful pessary fitting completed the satisfaction survey, 79% of whom were satisfied or very satisfied. Erosions (24.4%) were the most common complication. Difficulty in inserting or removing (30.4%) and erosions (22.8%) were the main factors, which affected the satisfaction degree.
Patients with obvious symptoms of posterior pelvic prolapse are more likely to fit failure. Difficulty in inserting or removing and erosions are the main factors, which lead to the discontinuation of pessary use and decrease in the satisfaction degree.
本研究旨在确定与子宫托适配、子宫托持续使用以及盆腔器官脱垂患者满意度相关的因素。
对接受初次子宫托适配的患者进行回顾性研究。记录这些患者的临床特征。采用盆底功能障碍指数PFDI - 20和PFIQ - 7评估盆底功能障碍和生活质量。在随访期间记录并发症、满意度及弃用原因。使用SPSS 20版中的t检验和卡方检验分析数据。
选取300例有症状脱垂的女性进行子宫托适配，平均年龄为67.8±10.7岁。249例（83%）女性适配成功，其中162例使用环形子宫托，87例使用盖尔霍恩子宫托。在研究结束时，47例患者弃用子宫托。成功适配组与未成功适配组的大多数临床特征无显著差异（P>0.05）。成功适配组的CRADI - 8平均得分（11.9±15.9）低于未成功适配组（18.8±19.9）（P<0.05）。162例子宫托适配成功的患者完成了满意度调查，其中79%的患者表示满意或非常满意。糜烂（24.4%）是最常见的并发症。插入或取出困难（30.4%）和糜烂（22.8%）是影响满意度的主要因素。
有明显盆腔后部脱垂症状的患者更易适配失败。插入或取出困难以及糜烂是导致子宫托停用和满意度降低的主要因素。
