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Vaginal pessary treatment of prolapse and incontinence

INTRODUCTION

Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions, with prevalence rates of 25 to 65 and 20 to 55 percent, respectively [1-6]. Surgical repair is one approach to treatment: approximately 200,000 women undergo surgery for POP and 135,000 women undergo surgery for SUI annually in the United States [7,8], and approximately 11 percent of women undergo surgery for POP or SUI by age 80; 30 percent of these women will have repeat surgery because of persistent or recurrent symptoms [9]. (See "An overview of the epidemiology, risk factors, clinical manifestations, and management of pelvic organ prolapse in women" and "Treatment and prevention of urinary incontinence in women".)

Vaginal pessaries are an alternative treatment option for women with these conditions.

INDICATIONS

A pessary trial can be offered to all women with pelvic organ prolapse (POP) or stress urinary incontinence (SUI), regardless of patient characteristics. Clinical settings where pessary use should be considered include:

Patient preference for nonsurgical treatment.

Presence of severe medical comorbidities that make the patient a poor surgical candidate.

                                    

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Literature review current through: Mar 2014. | This topic last updated: Mar 10, 2014.
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