ResearchGynecologyThe effect of pessaries on the vaginal microenvironment
Section snippets
Materials and Methods
Recruitment began after approval was obtained from the Hartford Hospital Institutional Review Board. Subjects were postmenopausal women who had either worn pessaries for at least 3 months (established users, hereafter termed ESTs) or who never had worn pessaries and were presenting for pessary fitting (new users, hereafter termed NEW). Women were approached for enrollment at outpatient visits to the urogynecology practice at Hartford Hospital, a tertiary care center.
Subjects met inclusion
Cross-sectional analysis
Each group (EST and NEW) consisted of 50 women (Table 1 presents baseline demographic and medical characteristics of both groups). The EST group was older and had been menopausal longer than the NEW group. Body mass index (EST, 27.0, SD, 4.6; NEW, 26.4, SD, 4.9; P = .57) and racial composition (white in 96% EST and 94% NEW subjects, P = 1.00) were similar between groups. Only 1 subject (in the EST group) was a smoker. Women in the EST group were more likely to be bothered by vaginal discharge
Comment
There are few objective differences between the vaginal microenvironments of women who wear pessaries and are bothered by discharge and those who wear pessaries and are not bothered. Although previous studies describe pessary-related vaginal discharge using diagnostic criteria for BV, we demonstrated that criteria for BV do not reliably identify correlate with bothersome discharge in postmenopausal women who wear pessaries. Furthermore, the microscopic changes that accompany an increase in
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Massive full-thickness mucosal defect of the anterior vaginal wall in ring pessary treatment
2023, European Journal of Obstetrics and Gynecology and Reproductive BiologyThe effect of time interval of vaginal ring pessary replacement for pelvic organ prolapse on complications and patient satisfaction: A randomised controlled trial
2019, MaturitasCitation Excerpt :Previous studies have shown that there was a change in intravaginal microbial flora after ring pessary therapy. There were inflammatory change and the anaerobic circumstances in vagina induced the growth of anaerobic bacteria [19,20]. Fregosi et al [21] found that the frequency of pessary removal was associated with changes in vaginal microenvironment.
Aerobic vaginitis: no longer a stranger
2017, Research in MicrobiologyCitation Excerpt :Pessary users with complaints of vaginitis were found to be carriers of enterococci, viridans streptococci and GBS more often, while new users more often had E. coli, viridans streptococci and enterococci. Diagnosis of AV using microscopy instead of cultures could help pessary users to better support the devices and better manage the vaginal discharge they sometimes have [30]. As is the case for BV, the pathogenesis of AV is not yet unravelled.
Pessaries for pelvic organ prolapse: evaluation of vaginal discharge and pain during pessary cleaning in an outpatient setting
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This study was supported by the Hartford Hospital Small Grant Program grant SG-123550.
The authors report no conflict of interest.
Cite this article as: Collins S, Beigi R, Mellen C, et al. The effect of pessaries on the vaginal microenvironment. Am J Obstet Gynecol 2015;212:60.e1-6.