A survey of pessary use by members of the American Urogynecologic Society
A survey of pessary use by members of the American Urogynecologic Society
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DOI：
10.1016/s0029-7844(00)00788-2
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发表时间：
2000-06-01
影响因子：
7.2
通讯作者：
Addison, WA
中科院分区：
文献类型：
--
作者：
Cundiff, GW;Weidner, AC;Addison, WA
目的：描述的趋势，在子宫托使用盆腔器官prolongation.Methods：一个匿名的调查管理的美国泌尿妇科学会的成员涵盖的适应症，管理和选择的子宫托特定的支持default.Results：回应率为48%（359 748）。科学会议收到了250份调查问卷，109份通过邮件退回。77%的人使用子宫托作为脱垂的一线治疗，而12%的人为非手术候选人保留子宫托。对于特定的支持缺损，89%的患者使用阴道托治疗前部缺损，60%的患者使用阴道托治疗后部缺损，74%的患者使用阴道托治疗根尖缺损，76%的患者使用阴道托治疗完全前突。22%的患者使用相同的子宫托，通常是环形子宫托，用于所有支持缺陷。在78%根据缺损量身定制子宫托的患者中，支持型子宫托更常见于前牙（环）和根尖缺损（环），而空间填充型子宫托更常见于后牙缺损（甜甜圈）和完全前牙（Gellhorn）。不到一半的人认为子宫切除术或性活动禁忌症的子宫托，而64%的人认为低雌激素的禁忌症。有44%的妇女使用不同的子宫托与先前子宫切除术和59%的妇女与薄弱的盆腔隔膜。92%的医生认为子宫托可缓解盆腔器官脱垂相关症状，而48%的医生认为子宫托除了缓解症状外，还具有治疗益处。虽然子宫托的使用有可识别的趋势，但与空间填充子宫托相比，关于支撑子宫托的适应症没有明确的共识，或者与针对特定缺陷定制子宫托相比，针对所有支撑缺陷使用单个子宫托。需要进行随机临床试验来确定最佳的子宫托使用。（《妇产科》，2000年;95：931- 935。(C)2000年由美国妇产科医师学会出版）。
Objective: To describe trends in pessary use for pelvic organ prolapse.Methods: An anonymous survey administered to the membership of the American Urogynecologic Society covered indications, management, and choice of pessary for specific support defects.Results: The response rate was 48% (359 of 748). Two hundred fifty surveys were received at the scientific meeting and 109 were returned by mail. Seventy-seven percent used pessaries as first-line therapy for prolapse, while 12% reserved pessaries for women who were not surgical candidates. With respect to specific support defects, 89% used a pessary for anterior defects, 60% for posterior defects, 74% for apical defects, and 76% for complete procidentia. Twenty-two percent used the same pessary, usually a ring pessary, for all support defects. In the 78% who tailored the pessary to the defect, support pessaries were more common for anterior (ring) and apical defects (ring), while space-filling pessaries were more common for posterior defects (donut) and complete procidentia (Gellhorn). Less than half considered a prior hysterectomy or sexual activity contraindications for a pessary, while 64% considered hypoestrogenism a contraindication. Forty-four percent used a different pessary for women with a prior hysterectomy and 59% for women with a weak pelvic diaphragm. Ninety-two percent of physicians believed that pessaries relieve symptoms associated with pelvic organ prolapse, while 48% felt that pessaries also had therapeutic benefit in addition to relieving symptoms.Conclusion: While there are identifiable trends in pessary use, there is no clear consensus regarding the indications for support pessaries compared with space-filling pessaries, or the use of a single pessary for all support defects compared with tailoring the pessary to the specific defect. Randomized clinical trials are needed to define optimal pessary use. (Obstet Gynecol 2000;95:931-5. (C) 2000 by The American College of Obstetricians and Gynecologists).