Do Pessaries Prevent the Progression of Pelvic Organ Prolapse?

Pessaries are used for the management of pelvic organ prolapse, but it is unknown whether a pessary will prevent progression of this condition. The purpose of this study was to describe the course of pelvic organ prolapse among women using a pessary for at least 1 year. Among 56 consecutive women fitted with a pessary, 19 (33.9%) continued its use under our care for at least 1 year. We compared baseline and follow-up examinations, using the Pelvic Organ Prolapse Quantitation examination system. At baseline, 16 (84.2%) had stage 3 or 4 prolapse. After 1 year we observed a significant improvement in the stage of disease (P = 0.045, Wilcoxon signed rank test). Four women (21.1%, 95% confidence interval −0.2, 43.7%) had an improvement in stage. No women had worsening in stage of prolapse. These data suggest that there may be a therapeutic effect associated with the use of a supportive pessary. Correspondence and offprint requests to: Dr V. L. Handa, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 600 North Wolfe Street, Harvey 319, Baltimore, MD 21287, USA. Tel: (410) 614-4495; Fax: (410) 955-1003; Email: vhanda1@jhmi.edu