Discontinuation of pessary therapy within 24 months: can it be predicted?

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Archives of Gynecology and Obstetrics Pub Date : 2024-12-01 Epub Date: 2024-11-30 DOI:10.1007/s00404-024-07846-y
L M Elting, L R van der Vaart, C H van der Vaart, A Vollebregt
{"title":"Discontinuation of pessary therapy within 24 months: can it be predicted?","authors":"L M Elting, L R van der Vaart, C H van der Vaart, A Vollebregt","doi":"10.1007/s00404-024-07846-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic organ prolapse is a distressing condition affecting women. Pessary therapy is a conservative and effective treatment option. However, 20-60% of women discontinue pessary treatment within 24 months.</p><p><strong>Objective: </strong>To identify patient characteristics associated with discontinuation of pessary treatment for symptomatic pelvic organ prolapse up to 24 months and to explore whether a prediction model can be developed.</p><p><strong>Study design: </strong>Prospective observational study in 22 Dutch hospitals with a follow-up duration of 24 months.</p><p><strong>Method: </strong>Baseline patient characteristics from 6 different domains were compared between women who continued pessary therapy and women who discontinued pessary therapy within 24 months. Women with initial fitting failure were not included in analysis. Univariable and multivariable analysis were applied to identify predictors.</p><p><strong>Results: </strong>Of the 251 women included in analysis, 102 stopped using a pessary at 24 months (40.6%). After multivariable analysis, age (OR 0.95, 95% CI 0.92-0.98, p < 0.001) and the presence of patient-reported allergies (OR 2.48, 95% CI 1.32-4.66, p = 0.005) were found to be predictive for pessary discontinuation within 24 months. These two factors explain 11% of the models' variance. However, in 49% of patient-reported allergies, the allergy was not specified.</p><p><strong>Conclusion: </strong>Younger women and those who reported allergies at baseline were less likely to continue pessary use. However, the high number of unspecified reported allergies and the lack of a clear scientific explanation, suggests that a direct causal link is unlikely and warrants additional research.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":"3279-3288"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Gynecology and Obstetrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00404-024-07846-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Pelvic organ prolapse is a distressing condition affecting women. Pessary therapy is a conservative and effective treatment option. However, 20-60% of women discontinue pessary treatment within 24 months.

Objective: To identify patient characteristics associated with discontinuation of pessary treatment for symptomatic pelvic organ prolapse up to 24 months and to explore whether a prediction model can be developed.

Study design: Prospective observational study in 22 Dutch hospitals with a follow-up duration of 24 months.

Method: Baseline patient characteristics from 6 different domains were compared between women who continued pessary therapy and women who discontinued pessary therapy within 24 months. Women with initial fitting failure were not included in analysis. Univariable and multivariable analysis were applied to identify predictors.

Results: Of the 251 women included in analysis, 102 stopped using a pessary at 24 months (40.6%). After multivariable analysis, age (OR 0.95, 95% CI 0.92-0.98, p < 0.001) and the presence of patient-reported allergies (OR 2.48, 95% CI 1.32-4.66, p = 0.005) were found to be predictive for pessary discontinuation within 24 months. These two factors explain 11% of the models' variance. However, in 49% of patient-reported allergies, the allergy was not specified.

Conclusion: Younger women and those who reported allergies at baseline were less likely to continue pessary use. However, the high number of unspecified reported allergies and the lack of a clear scientific explanation, suggests that a direct causal link is unlikely and warrants additional research.

24个月内停止必要治疗:可以预测吗?
盆腔器官脱垂是一种困扰女性的疾病。子宫托治疗是一种保守有效的治疗方法。然而,20-60%的妇女在24个月内停止必要的治疗。目的:确定症状性盆腔器官脱垂患者停止必要治疗长达24个月的相关特征,并探讨是否可以建立预测模型。研究设计:在荷兰22家医院进行前瞻性观察研究,随访时间为24个月。方法:比较在24个月内继续接受子宫托治疗的妇女和停止子宫托治疗的妇女在6个不同领域的基线患者特征。初始拟合失败的女性不包括在分析中。采用单变量和多变量分析来确定预测因子。结果:在纳入分析的251名妇女中,102名在24个月时停止使用子宫托(40.6%)。多变量分析后,年龄(OR 0.95, 95% CI 0.92-0.98, p)结论:年轻女性和基线时报告过敏的女性继续使用必要药物的可能性较小。然而,大量未明确的过敏报告和缺乏明确的科学解释表明,直接的因果关系不太可能,需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信