Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit
Objective: To determine the rate of adverse events (AE) in women who self-manage their vaginal ring pessary on a monthly basis. We hypothesised that the AE rate would be lower compared to previously published traditional management protocols. Study design: Audit study of 75 women with pelvic organ p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590161322000254 |
| _version_ | 1811201767706198016 |
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| author | Kate H. Moore Karin Lammers Wendy Allen Katrina Parkin Nevine te West |
| author_facet | Kate H. Moore Karin Lammers Wendy Allen Katrina Parkin Nevine te West |
| author_sort | Kate H. Moore |
| collection | DOAJ |
| description | Objective: To determine the rate of adverse events (AE) in women who self-manage their vaginal ring pessary on a monthly basis. We hypothesised that the AE rate would be lower compared to previously published traditional management protocols. Study design: Audit study of 75 women with pelvic organ prolapse and/or stress incontinence, who were fitted with a vaginal ring pessary during a five-year period, and who have self-managed their vaginal rings for at least two years, in a tertiary referral urogynaecology clinic. Main outcome measures: AEs included vaginal bleeding, malodorous vaginal discharge, extrusion of the device, pain/discomfort, and disorders of defaecation or de novo urinary incontinence. AEs that led to discontinuation of usage were termed “major”. Results: Of the 75 women who were taught to self-manage their ring pessary, 68 were initially successful. At a median follow-up of 50.5 months [IQR 43–76 months; median 4.2 years], 36 women (52.9%) were still using their ring pessary. Five women (7.4%) had vaginal erosions and bleeding leading them to cease pessary use (four proceeded to surgery). Three minor AEs were identified (4.4%), resolving after discontinuation of ring use two weeks. Thus, the overall AE rate was 11.8% (8/68). Conclusions: In contrast to previous published AE rates of 43–56% in women having ring changes at a clinic every 4–6 months, the AE rate was 12% in the women who performed monthly self-management of vaginal ring pessaries. Such information should be made available to patients considering a vaginal ring pessary. |
| first_indexed | 2024-04-12T02:27:27Z |
| format | Article |
| id | doaj.art-169a33af1b3a43d2b13afe60489f1f92 |
| institution | Directory Open Access Journal |
| issn | 2590-1613 |
| language | English |
| last_indexed | 2024-04-12T02:27:27Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| spelling | doaj.art-169a33af1b3a43d2b13afe60489f1f922022-12-22T03:51:55ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132022-12-0116100164Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical auditKate H. Moore0Karin Lammers1Wendy Allen2Katrina Parkin3Nevine te West4Department of Urogynaecology, St George Hospital, University of New South Wales, Gray Street, Kogarah, Sydney, NSW 2217, Australia; Correspondence to: Department of Urogynaecology, University of New South Wales, Level 1, W.R. Pitney Clinical Sciences Building, St George Hospital, Gray Street Kogarah, Sydney, NSW 2217, Australia.Pelvic Floor Unit, St George Hospital, Gray Street, Kogarah, Sydney, NSW 2217, Australia; Department of Urogynaecology, Martini Hospital, Van Swietenlaan 1, 9728 NT, Groningen, the NetherlandsPelvic Floor Unit, St George Hospital, Gray Street, Kogarah, Sydney, NSW 2217, AustraliaPelvic Floor Unit, St George Hospital, Gray Street, Kogarah, Sydney, NSW 2217, AustraliaPelvic Floor Unit, St George Hospital, Gray Street, Kogarah, Sydney, NSW 2217, AustraliaObjective: To determine the rate of adverse events (AE) in women who self-manage their vaginal ring pessary on a monthly basis. We hypothesised that the AE rate would be lower compared to previously published traditional management protocols. Study design: Audit study of 75 women with pelvic organ prolapse and/or stress incontinence, who were fitted with a vaginal ring pessary during a five-year period, and who have self-managed their vaginal rings for at least two years, in a tertiary referral urogynaecology clinic. Main outcome measures: AEs included vaginal bleeding, malodorous vaginal discharge, extrusion of the device, pain/discomfort, and disorders of defaecation or de novo urinary incontinence. AEs that led to discontinuation of usage were termed “major”. Results: Of the 75 women who were taught to self-manage their ring pessary, 68 were initially successful. At a median follow-up of 50.5 months [IQR 43–76 months; median 4.2 years], 36 women (52.9%) were still using their ring pessary. Five women (7.4%) had vaginal erosions and bleeding leading them to cease pessary use (four proceeded to surgery). Three minor AEs were identified (4.4%), resolving after discontinuation of ring use two weeks. Thus, the overall AE rate was 11.8% (8/68). Conclusions: In contrast to previous published AE rates of 43–56% in women having ring changes at a clinic every 4–6 months, the AE rate was 12% in the women who performed monthly self-management of vaginal ring pessaries. Such information should be made available to patients considering a vaginal ring pessary.http://www.sciencedirect.com/science/article/pii/S2590161322000254Conservative managementComplicationsPelvic organ prolapseSelf-managementVaginal ring pessary |
| spellingShingle | Kate H. Moore Karin Lammers Wendy Allen Katrina Parkin Nevine te West Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit European Journal of Obstetrics & Gynecology and Reproductive Biology: X Conservative management Complications Pelvic organ prolapse Self-management Vaginal ring pessary |
| title | Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit |
| title_full | Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit |
| title_fullStr | Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit |
| title_full_unstemmed | Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit |
| title_short | Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit |
| title_sort | does monthly self management of vaginal ring pessaries reduce the rate of adverse events a clinical audit |
| topic | Conservative management Complications Pelvic organ prolapse Self-management Vaginal ring pessary |
| url | http://www.sciencedirect.com/science/article/pii/S2590161322000254 |
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