Article Sidebar
Main Article Content
Abstract
Background: Pelvic organ prolapse (POP) represents a profound failure of pelvic floor anatomy, significantly impairing patient quality of life through complex functional and anatomical derangements. Vaginal pessaries stand as the primary conservative intervention. However, the contemporary literature remains fragmented regarding their long-term adherence kinetics and comparative pathophysiological efficacy against definitive surgical reconstruction.
Methods: A systematic review and meta-analysis were conducted, adhering strictly to PRISMA 2020 guidelines. Major scientific databases, including PubMed, Scopus, and Cochrane CENTRAL, were systematically searched for randomized controlled trials and prospective cohorts published between 2016 and 2026. Data synthesis employed a random-effects model, calculating Standardized Mean Differences (SMD) for validated symptom scores and pooled prevalence for longitudinal continuation and adverse events.
Results: Seven major studies comprising 2,772 participants were included. The pooled short-term continuation rate under twelve months was 76.6% (95% CI 68.2–85.0%), which demonstrated a predictable decline to 53.4% (95% CI 45.1–61.7%) beyond one year. Meta-analysis of validated symptom scores (PFDI-20) demonstrated a robust, transformative reduction in prolapse distress (SMD -1.24; 95% CI -1.56 to -0.92, p < 0.0001), showing statistical equivalence to surgical outcomes in advanced prolapse cohorts. Adverse events were uniformly mild, dominated by vaginal discharge (pooled prevalence 18.6%) and occult stress incontinence (11.4%).
Conclusion: Vaginal pessaries provide a high magnitude of pathophysiological symptom relief that parallels surgical correction in the short to medium term. By biomechanically restoring the pelvic axes, pessaries neutralize visceral nerve traction. While long-term continuation inevitably declines due to behavioral fatigue, the superior safety profile establishes pessaries as a definitive therapeutic modality.
Keywords
Article Details
As our aim is to disseminate original research article, hence the publishing right is a necessary one. The publishing right is needed in order to reach the agreement between the author and publisher. As the journal is fully open access, the authors will sign an exclusive license agreement.
The authors have the right to:
- Share their article in the same ways permitted to third parties under the relevant user license.
- Retain copyright, patent, trademark and other intellectual property rights including research data.
- Proper attribution and credit for the published work.
For the open access article, the publisher is granted to the following right.
- The non-exclusive right to publish the article and grant right to others.
- For the published article, the publisher applied for the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
