The Long-Term Effects of Pessary Treatment on Quality of Life, Symptoms, Sexual Function, and the Urinary System in Women with Pelvic Organ Prolapse.

Abstract

Introduction and hypothesis: Although pessary treatment is widely used to treat pelvic organ prolapse (POP), there is currently no clear information on its impact on long-term quality of life. The aim of this study was to examine the effects of pessary treatment on quality of life (QoL), symptoms, sexual function, and the urinary system in women with POP.

Methods: Patients who presented to our clinic due to POP and were treated with a pessary were evaluated. To examine the effects of pessary treatment on QoL, the urinary system, and sexual function, validated questionnaires, including the Pelvic Floor Distress Inventory-20 (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ), and the Female Sexual Function Index (FSFI), were completed by those who continued to receive pessary treatment. The patients' gynecological examinations were performed.

Results: Seventy patients were enrolled in the study. Four patients died owing to systemic comorbidities. Among the remaining patients, 12 discontinued pessary use (mean duration 27.36 months), while 54 continued the treatment (mean duration 25.43 months). The pessary size, total vaginal length (TVL), and genital hiatus (GH) of women with POP who discontinued treatment were greater than those who continued treatment. Previous gynecological operations and increased TVL were effective predictors for discontinuation of treatment. The total score and subheadings of the PFDI-20; PFIQ total score and subheadings, with the exception of the Colorectal-Anal Impact Questionnaire (CRAIQ-7); and FSFI scores improved after pessary treatment. Among patients who discontinued treatment, pain was the most common reason (41.6%).

Conclusions: Pessary treatment was associated with improvements in pelvic floor-related quality of life and sexual function; however, pain emerged as the primary reason for treatment discontinuation.