Effectiveness of Vaginal Pessary Use in Improving Quality of Life Among Women with Pelvic Organ Prolapse: A Prospective Study

TL;DR

Vaginal pessaries significantly improved quality of life for women with pelvic organ prolapse in Vietnam, with high satisfaction and few side effects.

Contribution

This study provides local evidence on the effectiveness of vaginal pessaries for treating pelvic organ prolapse in Vietnam.

Findings

95.4% of women successfully used pessaries with significant improvements in quality of life scores.

98.5% of participants reported symptomatic improvement and 95.4% were satisfied with treatment.

Pessary use was safe and well-tolerated, with few discontinuations due to side effects.

Abstract

What are the main findings?
Vaginal pessaries worked with high success, improvements in quality of life, and few side effects.Most women were satisfied and felt their symptoms improved.

Vaginal pessaries worked with high success, improvements in quality of life, and few side effects.

Most women were satisfied and felt their symptoms improved.

What are the implications of the main finding?
Pessaries can be used as an easy, safe first choice for women with prolapse.Offering pessary care in more hospitals could reduce the need for surgery.

Pessaries can be used as an easy, safe first choice for women with prolapse.

Offering pessary care in more hospitals could reduce the need for surgery.

Background: Pelvic organ prolapse (POP) significantly impairs women’s quality of life (QoL), particularly in resource-limited settings where surgical options may be restricted. Vaginal pessaries provide a conservative and cost-effective treatment, yet local evidence on their effectiveness in Vietnam remains scarce. Methods: In this six-month prospective study, 130 women with stage II–IV POP received vaginal pessaries. QoL was evaluated using validated PFDI-20 and PFIQ-7 questionnaires, and changes in symptoms, satisfaction, and adverse events were analyzed. Results: Most women presented with advanced POP (65.4% stage III, 19.2% stage IV). Ring pessaries were most frequently used (64.6%), followed by Gellhorn (23.9%) and Donut (11.5%). Successful fitting was achieved in 95.4% of participants, with six women discontinuing use due to expulsion or discomfort. QoL scores improved significantly after six months: mean PFDI-20 total decreased from 78.5 ± 51.4 to 42.2 ± 38.3 (p < 0.001), and PFIQ-7 total decreased from 62.6 ± 43.2 to 25.1 ± 22.9 (p < 0.001), with all subscales showing consistent improvement. Nearly all women (98.5%) reported symptomatic improvement, and 95.4% were satisfied with treatment. Correlation analyses showed no significant relationships between POP stage and obstetric factors (vaginal delivery, macrosomia, and episiotomy). In multivariate regression analysis including only age, BMI, and POP stage, none were significantly associated with QoL improvement. Conclusions: Vaginal pessary use was safe, highly effective, and well tolerated, leading to symptom and QoL improvements among Vietnamese women with advanced POP. These findings support pessary use as a first-line management option, especially for women who are elderly, have comorbidities, or lack access to surgery.