盆腔器官脱垂保守治疗中使用阴道子宫托选择的人口统计学、社会经济和功能健康相关因素：一项回顾性研究
Demographic, socioeconomic and functional health-related factors in the selection of vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a retrospective study.
作者信息
Oláh Orsolya, Romics Miklós, Ács Nándor, Cseh Richárd, Nyirády Péter, Majoros Attila
机构信息
Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, H-1082, Hungary.
Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, H-1082, Hungary.
出版信息
BMC Womens Health. 2025 Aug 13;25(1):390. doi: 10.1186/s12905-025-03923-9.
BACKGROUND
Vaginal pessary therapy is a well-known conservative treatment of pelvic organ prolapse (POP). According to several national guidelines, pessary therapy should be used as a first-line treatment for pelvic organ prolapse. A distinction is made between pessaries that can be worn permanently or require daily control. This therapy is primarily chosen by elderly patients who are not suitable for surgery or by patients not wishing to undergo surgical treatment. The aim of our study was to investigate what demographic, socioeconomic and functional health-related factors play a role in the choice of the pessary types, and to provide healthcare professionals with guidance on recommending a pessary type to patients based on these factors.
METHODS
115 female patients using vaginal pessaries for POP were included in our study (group I:73 pts used a daily control "cube" pessary (DCP), group II.:42 pts used a long-term wear ring pessary (LTP). Data collection was performed between March 2021 and March 2022 through a personally completed questionnaire or telephone interview. The following factors were investigated: patients' age, fertility, education level, employment status, marital status, independence, hand function, vision, mobility, physical and sexual activity.
RESULTS
A significant difference was found between the DCP and LTP groups in terms of average age (44.9 vs. 75.7 years p < 0.0001), fertility (61.6 vs. 4.6% p < 0.0001), employment status (retired: 18 vs. 100% p < 0.0001), marital status (single: 8.3 vs. 44.1% p < 0.0001) and educational level (highest: 81.9 vs. 25.6% p < 0.0001). In terms of functional health-related factors, such as weakened hand function (1.4 vs. 34.9% p < 0.0001), vision impairment (19.4 vs. 58.1% p < 0.0001), reduced mobility (5.5 vs. 81.4% p < 0.0001), sexual activity ratio (87.5 vs. 0% p < 0.0001), and the level of physical activity (VAS: 9.5 vs. 6.1 p < 0.01) also significant differences were registered between the DCP and LTP groups.
CONCLUSIONS
The choice of the type of vaginal pessary treatment for POP is influenced by many patient-side factors.
TRIAL REGISTRATION
The study was conducted with the approval of the Regional Institutional Scientific and Research Ethics Committee of Semmelweis University (SE RKEB 97/2022).
背景
阴道子宫托疗法是一种广为人知的盆腔器官脱垂（POP）保守治疗方法。根据多项国家指南，子宫托疗法应作为盆腔器官脱垂的一线治疗方法。可长期佩戴或需每日检查的子宫托有所不同。这种疗法主要由不适合手术的老年患者或不愿接受手术治疗的患者选择。我们研究的目的是调查哪些人口统计学、社会经济和功能健康相关因素在子宫托类型的选择中起作用，并根据这些因素为医护人员向患者推荐子宫托类型提供指导。
方法
我们的研究纳入了115名使用阴道子宫托治疗POP的女性患者（第一组：73名患者使用每日检查的“立方体”子宫托（DCP），第二组：42名患者使用长期佩戴的环形子宫托（LTP））。2021年3月至2022年3月期间，通过个人填写问卷或电话访谈进行数据收集。调查了以下因素：患者的年龄、生育情况、教育水平、就业状况、婚姻状况、独立性、手部功能、视力、行动能力、身体和性活动。
结果
DCP组和LTP组在平均年龄（44.9岁对75.7岁，p<0.0001）、生育情况（61.6%对4.6%，p<0.0001）、就业状况（退休：18%对100%，p<0.0001）、婚姻状况（单身：8.3%对44.1%，p<0.0001）和教育水平（最高：81.9%对25.6%，p<0.0001）方面存在显著差异。在功能健康相关因素方面，如手部功能减弱（1.4%对34.9%，p<0.0001）、视力障碍（19.4%对58.1%，p<0.0001）、行动能力下降（5.5%对81.4%，p<0.0001）、性活动比例（87.5%对0%，p<0.0001）以及身体活动水平（视觉模拟评分法：9.5对6.1，p<0.01），DCP组和LTP组之间也存在显著差异。
结论
POP阴道子宫托治疗类型的选择受许多患者方面因素的影响。
试验注册
本研究经塞梅尔维斯大学地区机构科研伦理委员会批准进行（SE RKEB 97/2022）。
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