E-Posters-Does Monthly Self-Management of Vaginal Ring Pessaries Reduce Complication Rates?

Does Monthly Self-Management of Vaginal Ring Pessaries Reduce Complication Rates? - Karin Lammers, MD, PhD

Pdf Summary

A clinical audit was conducted to determine the complication rates of vaginal ring pessaries in women who self-manage their pessaries. The study included a retrospective and current case note review of women who had used a pessary for at least 2 years in a tertiary referral urogynaecology unit. Complications such as vaginal bleeding, malodorous vaginal discharge, extrusion of the device, pain/discomfort, and disorders of defaecation or new urinary incontinence were noted. Of the 75 women taught to self-manage their pessaries, 68 were initially successful, with 36 women still using their pessary rings. Five women had vaginal erosions and bleeding leading to discontinuation of pessary use, and four of them underwent surgery. Three minor complications were resolved after discontinuation of ring use for two weeks. Overall, the complication rate was 11.8%. <br /><br />The study found that monthly self-management of vaginal ring pessaries can reduce the rate of complications when compared to pessaries changed every 4-6 months in a clinic by a medical professional. This finding is particularly important as gynaecologists have largely abandoned the use of vaginal mesh for prolapse repair. The self-management approach provides women with greater control over their prolapse and/or incontinence problems and is likely to result in cost-savings for the health service. The study suggests that this information should be shared with patients when discussing treatment options. <br /><br />In conclusion, monthly self-management of vaginal ring pessaries can significantly reduce the rate of complications and offer women greater control over their conditions. The study findings have implications for treatment options and potential cost-savings in the healthcare system.

Keywords

clinical audit

vaginal ring pessaries

self-management

complication rates

retrospective case note review

tertiary referral urogynaecology unit

vaginal bleeding

malodorous vaginal discharge

extrusion of device

pain/discomfort