TITLE:
Prospective Evaluation of Outcomes of Mechanical Devices in Women with Symptomatic Pelvic Organ Prolapse in Ogbomoso, South-Western Nigeria
AUTHORS:
Akintunde Olusegun Fehintola, Olufemi Timothy Awotunde, Olumuyiwa Ayotunde Ogunlaja, Lawrence Olujire Olujide, Samuel Eniola Akinola, Sunday Adekunle Oladeji, Babatola Bakare, Olurotimi Idowu Aaron
KEYWORDS:
Mechanical Device, Symptomatic Pelvic Organ Prolapse, Complications, Dis-continuation
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.4,
April
27,
2021
ABSTRACT: Background: Symptomatic pelvic organ prolapse (POP) impacts the sufferers’ quality of life negatively.
There is a preference for a mechanical device in certain conditions though the
definitive management of POP is surgical. Objectives: We conducted the study to evaluate
the outcome of management of POP using mechanical devices. Methods: It was a prospective study.
It took place in the gynecology unit of the Bowen University Teaching Hospital
Ogbomoso between May 2014 and April 2019. We followed up with eligible patients who opted
for pessary use for a median duration of 18 months (Range 12 - 84 months).
We excluded those who refuse to participate in the study. Results: Of
the 127 patients with symptomatic POP, seventy-five
(59.1%) opted for the use of mechanical devices, and 70 successfully retained
them four weeks after insertion. We lost Six (9.2%) patients to follow up. Of
the 64 women included in the analysis, 16 (25%) discontinued use at some point
after four weeks, whereas 36 (56.3%) used the pessary successfully throughout
the follow-up period. Overall, 12.1% of the women experienced minor
complications (6.9% pain or discomfort, 3.2% excoriation or bleeding, and 2.0%
dis-impaction or constipation). After cessation of pessary use, 12 (25%) of the
48 women chose surgery, and 10 (20.8%) chose no further treatment. Conclusion: This study concluded that pessary use for pelvic organ prolapse is safe in
low resource settings. Therefore, it is justifiable to offer pessaries in the
initial management of uterovaginal prolapse to all patients who opt for
conservative management and those awaiting surgery.