Oh Sumin, Namkung Hye Ryun, Yoon Hee Yeon, Lee So Yeon, Jeon Myung Jae
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2022 Jan;65(1):94-99. doi: 10.5468/ogs.21232. Epub 2021 Dec 13.
To identify the factors associated with unsuccessful pessary fitting and reasons for pessary discontinuation in Korean women with pelvic organ prolapse (POP).
The medical records of 234 patients who underwent pessary fitting for the management of symptomatic POP were retrospectively reviewed. A ring pessary with or without support was used. Successful pessary fitting was defined as the ability to wear a pessary for 2 weeks without any discomfort. Factors associated with unsuccessful pessary fitting were determined using a multivariable logistic regression analysis. A Kaplan-Meier survival curve was obtained to examine the probability of continuing pessary use over the follow-up period. The reasons for the discontinuation of pessary were identified.
Two-hundred-and-twenty-five women were included in the analysis. The rate of unsuccessful pessary fitting was 40%. Prior hysterectomy (odds ratio [OR], 4.13; 95% confidence interval [CI], 1.81-9.42) and POP quantification stage III-IV (OR, 2.49; 95% CI, 1.28-4.85) were independent risk factors for unsuccessful pessary fitting. Among the patients with successful pessary fitting, the median time to discontinuation of pessary use was 4 years. The most common causes of discontinued use were vaginal erosion (45.3%) and urinary incontinence (26.5%).
Patients with a history of hysterectomy and advanced-stage POP are at risk for an unsuccessful fitting of the ring pessary. Vaginal erosion is the main reason for discontinued use among patients with successful pessary fitting.
确定韩国盆腔器官脱垂（POP）女性子宫托适配失败的相关因素以及子宫托停用的原因。
回顾性分析234例因有症状的POP而接受子宫托适配的患者的病历。使用有支撑或无支撑的环形子宫托。成功的子宫托适配定义为能够佩戴子宫托2周且无任何不适。采用多变量逻辑回归分析确定与子宫托适配失败相关的因素。绘制Kaplan-Meier生存曲线以检查随访期间继续使用子宫托的概率。确定子宫托停用的原因。
225名女性纳入分析。子宫托适配失败率为40%。既往子宫切除术（比值比[OR]，4.13；95%置信区间[CI]，1.81 - 9.42）和POP量化分期III - IV期（OR，2.49；95% CI，1.28 - 4.85）是子宫托适配失败的独立危险因素。在子宫托适配成功的患者中，子宫托停用的中位时间为4年。停用的最常见原因是阴道糜烂（45.3%）和尿失禁（26.5%）。
有子宫切除术史和晚期POP的患者环形子宫托适配失败的风险较高。阴道糜烂是子宫托适配成功患者停用的主要原因。
