The characteristics and satisfaction of the patients using vaginal pessaries.

OBJECTIVE: To study the characteristics of pelvic organ prolapse (POP) patients that used a pessary. DESIGN: Prospective, descriptive study. SETTING: Urogynecology Clinic, Ramathibodi Hospital, Faculty of Medicine, Mahidol University. MATERIAL AND METHOD: The authors conducted a prospective, observational study. The average age, parity, average body mass index, menopausal age, pessary type, and reasons for pessary use were collected in the present study. The symptoms, satisfaction, complication, and continuation rates after use were recorded. RESULTS: For the 40 subjects, the average age was 70.4 years, the average of parity, body mass index, and menopausal age were 4, 24.5 kg/m2, and 22 years, respectively. The reasons for choosing a pessary included mostly risks and reluctance to undergo surgery. The complications from using a pessary were vaginal erosion, which was found in one case. Thirty-seven patients (92.5%) were satisfied and continued to use pessaries. CONCLUSION: Most POP patients had a favorable outcome in terms of satisfaction with the pessary use and continued to use pessaries.

A randomized trial on the impact of starting day on ovarian follicular activity in very low dose oral contraceptive pills users.

In a randomized trial, the impact of starting day (the first and the seventh day of the period) on ovarian follicular activity was assessed during administration of a very low dose of oral contraceptive pills (20 microgram (mcg) ethinyl estradiol (EE) and 75 mcg gestodene (GS) [Meliane, Schering, Germany]). One hundred and sixty healthy women aged: 23-44 years, who had a regular cycle, and who were not using any type of oral contraceptive (OCs) steroid were studied at the Family Planning Clinic of King Chulalongkorn Memorial Hospital, Bangkok, Thailand. In the trial, each subject received a package of Meliane. They were blockwise randomized, 1:1 ratio; in the first group, subjects began their pills on the first day of their period (n = 80) and the other group, the seventh day of their period (n = 80). During the treatment cycle, ovarian activity was evaluated by transvaginal sonography (TVS) to determine the follicular-like structure (FLS). Ovulation was defined as the dominant FLS detected by TVS and followed-up every other day until its collapse. It occurred in 0 of 77 cases who started on the first day of their period and occurred in 8 of 78 cases of the group which started on the seventh day of their period. The difference was of statistical significance (p = 0.006). The result of this clinical trial is beneficial information for users of OCs containing 20 mcg EE who delay start of the OCs package.