ABSTRACT
OBJECTIVE: The purpose of this study was to evaluate whether patient determined goal achievement is associated with pessary continuation. STUDY DESIGN: Patients identified goals they wished to achieve from pessary use. Patients were asked whether they continued pessary use and if goals were met 6-12 months later. Goals were divided into 8 categories. Fisher exact test was used to evaluate categorical variables, t tests for continuous variables, and regression methods to calculate odds ratios (OR). RESULTS: Eighty women enrolled in the study. Sixty-four had follow-up data. Goals commonly listed were bladder (36%), activity (20%), general health (13%), and prolapse related (11%). Thirty-four women continued and 30 discontinued pessary use. Women who continued pessary use were more likely to meet 1 or 2 goals (OR 17.5, 21.1 and 95% CI 4.8-64.4, 5.7-78.9, respectively). CONCLUSION: Patient goals are variable and subjective. However, when assessed for achievement, they are associated with pessary continuation. Women who attain self-determined goals are likely to continue pessary use.
Subject(s)
Outcome Assessment, Health Care , Patient Satisfaction , Urinary Incontinence/therapy , Adult , Female , Goals , Health Status , Health Status Indicators , Humans , Middle Aged , Patient Compliance , Pessaries , Quality of Life , Urinary Bladder/physiopathologyABSTRACT
OBJECTIVE: The objective of the study was to compare pelvic floor symptom changes in patients who continue vs discontinue pessary use, and determine whether changes predict pessary continuation. STUDY DESIGN: Women fitted with pessaries completed the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary use. Scores were compared in women who continued vs discontinued pessaries. Analysis of covariance adjusted for baseline differences in scores. Logistic regression and receiver operating characteristic curves were used to find a score predicting pessary continuation. RESULTS: Sixty-four women had complete follow up data; at 6-12 months, 36 of 64 (56%) continued pessary use, and 28 of 64 (44%) discontinued use. The continuation group's final PFDI-20 total, bladder, and prolapse scale scores were better than the discontinuation group's. A 2-month prolapse score that fell to 50% of baseline best predicted pessary continuation. CONCLUSION: PFDI-20 scores improved most in women continuing pessary use. Pessaries effectively treated urinary symptoms, and most effectively treated prolapse symptoms. Prolapse score improvement best predicted continued pessary use.
