The effect of time interval of vaginal ring pessary replacement for pelvic organ prolapse on complications and patient satisfaction: A randomised controlled trial

Maturitas ◽  
2019 ◽  
Vol 128 ◽  
pp. 29-35
Author(s):  
Man-Sum Tam ◽  
Vicky Y.T. Lee ◽  
Ellen L.M. Yu ◽  
Rebecca S.F. Wan ◽  
Janet S.M. Tang ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e025141
Author(s):  
Tina Sara Verghese ◽  
Lee Middleton ◽  
Versha Cheed ◽  
Lisa Leighton ◽  
Jane Daniels ◽  
...  

ObjectiveTo evaluate the feasibility of a multicentre randomised controlled trial (RCT) comparing oestrogen treatment with no oestrogen supplementation in women undergoing pelvic organ prolapse (POP) surgery.Design and settingA randomised, parallel, open, external pilot trial involving six UK urogynaecology centres (July 2015–August 2016).ParticipantsPostmenopausal women with POP opting for surgery, unless involving mesh or for recurrent POP in same compartment.InterventionWomen were randomised (1:1) to preoperative and postoperative oestrogen or no treatment. Oestrogen treatment (oestradiol hemihydrate 10 μg vaginal pessaries) commenced 6 weeks prior to surgery (once daily for 2 weeks, twice weekly for 4 weeks) and twice weekly for 26 weeks from 6 weeks postsurgery.Outcome measuresThe main outcomes were assessment of eligibility and recruitment rates along with compliance and data completion. To obtain estimates for important aspects of the protocol to allow development of a definitive trial.Results325 women seeking POP surgery were screened over 13 months and 157 (48%) were eligible. Of these, 100 (64%) were randomised, 50 to oestrogen and 50 to no oestrogen treatment, with 89 (44/45 respectively) ultimately having surgery. Of these, 89% (79/89) returned complete questionnaires at 6 months and 78% (32/41) reported good compliance with oestrogen. No serious adverse events were attributable to oestrogen use.ConclusionsA large multicentre RCT of oestrogen versus no treatment is feasible, as it is possible to randomise and follow up participants with high fidelity. Four predefined feasibility criteria were met. Compliance with treatment regimens is not a barrier. A larger trial is required to definitively address the role of perioperative oestrogen supplementation.Trial registration numberISRCTN46661996.


2019 ◽  
Vol 14 (2) ◽  
pp. 46-48
Author(s):  
Madhu Shrestha

Aims: To evaluate the use of pessaries for women with Pelvic Organ Prolapse irrespectivve POP-Q stages. Method: This is retrospective study conducted at Paropakar maternity and Women’s hospital from mid April to mid December 2018 on 114 women with pelvic organ prolapse. Result: Total of 114 women with prolapse evaluated. Age of presentation ranged from 36 to 85 years. Twenty cases (17.6%) underwent prolapsed surgery and 71 cases (62.2%) had ring pessary. Conclusion: Overall acceptance of vaginal ring pessary is very high. It can be used in the majority of women with patient satisfaction and without noteworthy complication.


Sign in / Sign up

Export Citation Format

Share Document