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Complications of neglected vaginal pessaries: case presentation and literature review.

Publication ,  Journal Article
Arias, BE; Ridgeway, B; Barber, MD
Published in: Int Urogynecol J Pelvic Floor Dysfunct
August 2008

Vaginal pessaries are often used as first-line management of pelvic organ prolapse in women who are poor surgical candidates or who decline surgical repair. Mostly, pessaries are well tolerated but when neglected may lead to serious complications including vesicovaginal and rectovaginal fistulas. An 89-year-old woman presented with a large vesicovaginal fistula resulting from a Gellhorn pessary that had been neglected for 3 years. The base of the pessary had migrated completely inside the bladder and the fistulous opening measured 4 cm. The pessary was extracted under anesthesia using a Schuchardt incision to increase exposure. After 6 weeks of vaginal estrogen treatment, the fistula was successfully repaired using the Latzko partial colpocleisis technique. Neglect of a vaginal pessary can lead to serious complications. Patient education, local estrogen treatment, excellent fitting, and careful follow-up are of paramount importance in prevention of such complications.

Duke Scholars

Published In

Int Urogynecol J Pelvic Floor Dysfunct

DOI

Publication Date

August 2008

Volume

19

Issue

8

Start / End Page

1173 / 1178

Location

England

Related Subject Headings

  • Vesicovaginal Fistula
  • Uterine Prolapse
  • Time Factors
  • Rectovaginal Fistula
  • Pessaries
  • Obstetrics & Reproductive Medicine
  • Humans
  • Gynecologic Surgical Procedures
  • Female
  • Aged, 80 and over
 

Citation

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Arias, B. E., Ridgeway, B., & Barber, M. D. (2008). Complications of neglected vaginal pessaries: case presentation and literature review. Int Urogynecol J Pelvic Floor Dysfunct, 19(8), 1173–1178. https://doi.org/10.1007/s00192-008-0574-2
Arias, Beatriz E., Beri Ridgeway, and Matthew D. Barber. “Complications of neglected vaginal pessaries: case presentation and literature review.Int Urogynecol J Pelvic Floor Dysfunct 19, no. 8 (August 2008): 1173–78. https://doi.org/10.1007/s00192-008-0574-2.
Arias BE, Ridgeway B, Barber MD. Complications of neglected vaginal pessaries: case presentation and literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2008 Aug;19(8):1173–8.
Arias, Beatriz E., et al. “Complications of neglected vaginal pessaries: case presentation and literature review.Int Urogynecol J Pelvic Floor Dysfunct, vol. 19, no. 8, Aug. 2008, pp. 1173–78. Pubmed, doi:10.1007/s00192-008-0574-2.
Arias BE, Ridgeway B, Barber MD. Complications of neglected vaginal pessaries: case presentation and literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2008 Aug;19(8):1173–1178.

Published In

Int Urogynecol J Pelvic Floor Dysfunct

DOI

Publication Date

August 2008

Volume

19

Issue

8

Start / End Page

1173 / 1178

Location

England

Related Subject Headings

  • Vesicovaginal Fistula
  • Uterine Prolapse
  • Time Factors
  • Rectovaginal Fistula
  • Pessaries
  • Obstetrics & Reproductive Medicine
  • Humans
  • Gynecologic Surgical Procedures
  • Female
  • Aged, 80 and over