[Patient satisfaction and symptom changes in women using a pessary for pelvic organ prolapse]. / Satisfaction des patientes et efficacité du pessaire en cas de prolapsus des organes pelviens.

INTRODUCTION: Pessary is one of the commonly used conservative treatments of pelvic organ prolapse (POP). However, its use seems to be limited to elderly patients or in case refusal or contraindication to surgery. AIM: Our main objective was to evaluate and identify factors associated with satisfaction in women using a pessary. Secondary objectives were to assess improvement in symptom and quality of live scores and to identify factors associated with unsucessfull pessary use. METHODS: This was a prospective cohort study performed in a French teaching hospital in women with symptomatic POP. The primary endpoint was the PGI-I (Patient Global Impression of Improvement). Symptom improvement was assessed using the symptom scores (PFDI-20, ICIQ-SF, PISQ-12 and USP) and the PFIQ-7 quality of life score. RESULTS: Eighty five patients were included. The satisfaction rate was 78,1% at 1 month and 87,5% at 6months. The effectiveness of pessary was the main benefit reported by patients at both 1month (60%) and 6 months (59,4%). The only factors associated witch patient satisfaction were the greater improvement in symptoms (PFDI20 et PFIQ7; p<0.05). In case of failure, patients were significantly younger and overweight (p=0.001). CONCLUSION: The pessary is a true first-line treatments alternative of POP without major complications. Patient acceptance and satisfaction are important.

[The use of pessaries for treatment of pelvic organ prolapse: A survey from gynecologists and urologists residents]. / Utilisation du pessaire gynécologique en cas de prolapsus génital : une enquête auprès des internes.

INTRODUCTION: Pelvic organ prolapse (POP) is a common condition responsible for symptoms that significantly affect the quality of life in women. Despite its effectiveness, low cost and minor side effects, the pessary is little used in France. The objective of our study was to assess the knowledge, training and practices of residents regarding pessaries. MATERIAL AND METHODS: This survey was conducted among residents in obstetrics gynecology, medical gynecology and urology in France between March and September 2020. RESULTS: During the study period, 328 interns responded to the questionnaires. The majority of residents (52.1%) reported never having attended a consultation specializing in pelvicperineology. Only 31.7% felt comfortable having a pessary inserted. According to them, the pessary was indicated in 3 main situations: in case of contraindication to surgery (80%), while awaiting surgery (79%) and in women over 70 years old (62%). The pessary could be offered to all women for only 46.9% of them. Almost 53% of residents reported ignoring the main complications of pessaries and 83.5% felt they needed further training on the subject. CONCLUSION: Interns seem to be generally aware of the use of the pessary. Their knowledge of the indications, complications or even monitoring leads us to believe that it is essential to promote their training so that the pessary becomes an integral part of the first-line therapeutic arsenal in the event of POPs.