From the Department of OBGYN.
Division of Urogynecology, Department of OBGYN, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, South Shore University Hospital, New York, NY.
Female Pelvic Med Reconstr Surg. 2021 Mar 1;27(3):214-216. doi: 10.1097/SPV.0000000000001013.
The aims of this study were to determine the percentage of patients who opt to undergo pessary self-care versus those who return to the office for care and to identify any differences in the characteristics between the 2 groups.
This study is a retrospective chart review conducted at a tertiary care center. Demographic data; details regarding pessary use; body weight; pelvic organ prolapse stage; and medical, surgical, and obstetrical histories were evaluated. Variables were compared between groups of patients using the t test, Wilcoxon rank sum test, χ2 test, and Fisher exact test.
The rate of patients choosing to perform pessary self-care was 31%. The patients in the self-care group were significantly younger (65.0 vs 75.0 years, P < 0.001). Those who were performing self-care were more likely to be premenopausal (6.9% vs 1.5%, P = 0.003), have a lower stage of pelvic organ prolapse (61.3% vs 42.1%, P < 0.001), and more likely to be sexually active (40.5% vs 9.6%, P < 0.001). Those not performing self-care had higher rates of vaginal bleeding (26.0% vs 16.4%, P = 0.012) and erosion (23.5% vs 9.9%, P < 0.001). Self-care patients predominantly used the ring with support pessary, whereas those in the non-self-care group were mostly using the Gellhorn.
Only one third of patients who use a pessary chose to perform self-care. Patients who use self-care are younger, premenopausal, sexually active, and have lower degrees of prolapse. These data can help educate patients on the characteristics more often seen in those choosing self-care. This study highlights the importance of further exploring pessary care preferences and using this information for counseling.
本研究旨在确定选择自行护理子宫托与选择返诊护理的患者比例，并确定这两组患者在特征上的任何差异。
这是在一家三级保健中心进行的回顾性图表审查研究。评估了人口统计学数据；子宫托使用细节；体重；盆腔器官脱垂分期；以及医疗、手术和产科病史。使用 t 检验、Wilcoxon 秩和检验、χ2 检验和 Fisher 确切检验比较两组患者的变量。
选择自行护理子宫托的患者比例为 31%。自我护理组的患者明显更年轻（65.0 岁 vs 75.0 岁，P < 0.001）。进行自我护理的患者更有可能处于绝经前期（6.9% vs 1.5%，P = 0.003），盆腔器官脱垂程度较低（61.3% vs 42.1%，P < 0.001），且更活跃（40.5% vs 9.6%，P < 0.001）。不进行自我护理的患者阴道出血发生率较高（26.0% vs 16.4%，P = 0.012）和侵蚀发生率较高（23.5% vs 9.9%，P < 0.001）。自我护理患者主要使用带支撑环的子宫托，而非自我护理组患者主要使用 Gellhorn 子宫托。
只有三分之一使用子宫托的患者选择自行护理。选择自我护理的患者更年轻、绝经前、活跃，且脱垂程度较低。这些数据可以帮助教育患者了解选择自我护理的患者更常见的特征。本研究强调了进一步探讨子宫托护理偏好并利用这些信息进行咨询的重要性。
