Pelvik Organ Prolapsusu Olan Postmenapozal Kadınlarda Pesser Kullanımı ile Pesserle Beraber Lokal Östrojen Kullanımının Vajinal ve Üriner Etkilerinin Karşılaştırılması

Abstract

Aim: To investigate and compare the vaginal and urinary effects of the use of a vaginal pessary ring and vaginal local oestrogen together with pessary prescribed for postmenopausal women with pelvic organ prolapse (POP) who did not wish to have a POP operation. Method: This prospective case-control study was conducted in the Gynaecology and Obstetrics Clinics of Turhal State Hospital and Tokat State Hospital between May 2021 and July 2021. Two groups were formed of 25 patients given a vaginal pessary ring for treatment, and 25 who were given vaginal local oestrogen together with the pessary ring. Comparisons were made between the groups in respect of age, gravida, parity, pelvic pain, vaginal itching-discharge-dryness-bleeding, findings of urinary incontinence, the presence of bacteria in the urine, and white blood cells (WBC) and c reavtive protein (CRP) values. Results: In the comparisons of women using pessary alone and those using local oestrogen together with the pessary, the complaints of pelvic pain (p=0.034) and vaginal dryness (p=0.037) were determined at a higher rate in the group that used the pessary alone. Conclusion: The reason for the higher rate of pelvic pain and vaginal dryness seen in the women using pessary alone is that without oestrogen the pessary has the effect of a foreign body on the vaginal mucosa, thereby increasing vaginal inflammation. However, local oestrogen increased the complaint of unnecessary vaginal bleeding in some patients. Taking all these findings in to consideration, the use of pessary and local oestrogen should be applied carefully in POP treatment.