Calidad de vida de pacientes con distopias vaginales tratadas con pessário
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Apr 30, 2023
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Resumen
Objetivo: Evaluar la mejoría en la calidad de vida de las pacientes en tratamiento con pesario para corregir distopías vaginales, así como evaluar qué dominios de la vida tuvieron mayor impacto. Métodos: Se realizó un estudio observacional, transversal y descriptivo con pacientes que utilizaron el pesario como opción de tratamiento conservador para las distopías vaginales y se encuentran en seguimiento en un hospital regional del Distrito Federal. Resultados: Se incluyeron tres pacientes que cumplieron con los criterios de inclusión propuestos para este estudio. Hubo una mejora significativa en los dominios relacionados con limitaciones físicas/sociales (de 21 a 0 puntos) y emociones (44 a 0), que fueron los que tuvieron mejores desempeños. Los dominios referentes a las limitaciones de las actividades cotidianas y de las relaciones personales se mantuvieron sin cambios. Y los dominios relacionados con percepción general de salud (de 61 a 44 puntos), impacto del prolapso (de 46 a 33 puntos), sueño/energía (de 12 a 4 puntos) y severidad de los síntomas (de 20 a 10 puntos), tuvieron una mejora razonable. Conclusión: Se concluye que hubo una mejoría en la calidad de vida de las pacientes luego de seis meses de seguimiento del tratamiento conservador de la distopía genital con pesario.
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Cómo citar
LeiteA. B., SouzaN. M. de P., & AdornoG. R. (2023). Calidad de vida de pacientes con distopias vaginales tratadas con pessário. Revista Eletrônica Acervo Saúde, 23(4), e12339. https://doi.org/10.25248/reas.e12339.2023
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1. BØ K, et al. International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training. Int Urogynecol J., 2022; 33(10): 2633-2667.
2. BELAYNEH T, et al. Pelvic organ prolapse surgery and health-related quality of life: a follow-up study. BMC Womens Health., 2021; 21(1): 1-4.
3. BODNER-ADLER B, et al. Prolapse surgery versus vaginal pessary in women with symptomatic pelvic organ prolapse: which factors influence the choice of treatment? Arch Gynecol Obstet. 2019; 299(3): 773–777.
4. BRANDT C e VUUREN ECJV. Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse. S Afr J Physiother. 2019; 75(1): e933.
5. BROWN L, et al. Defining patient knowledge and perceptions of vaginal pessaries for prolapse and incontinence. Female Pelvic Med Reconstr Surg., 2016; 22(2): 93-97.
6. BUGGE C, et al. Pessaries (mechanical devices) for managing pelvic organ prolapse in women. Cochrane Database Syst Rev., 2020; 11(11): CD004010.
7. BUMP RC, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol, 1996; 175(1): 10-17.
8. CARRAMÃO S, et al. Estudo randômico da correção cirúrgica do prolapso uterino através de tela sintética de polipropileno tipo I comparando histerectomia versus preservação uterina. Rev. Col. Bras. Cir., 2009; 36(1): 65-72.
9. CARROLL L, et al. Pelvic organ prolapse: The lived experience. PLoS One., 2022; 17(11): e0276788.
10. COELHO SA, et al. Factors associated with the prescription of vaginal pessaries for pelvic organ prolapse. Clínicas (São Paulo), 2019; 74(1): e934.
11. COELHO S, et al. Quality of life and vaginal symptoms of postmenopausal women using pessary for pelvic organ prolapse: a prospective study. Rev Assoc Med Bra. 2018; 64(12): 1103-1107.
12. CONWAY CK, et al. Pelvic Organ Prolapse: A Review of In Vitro Testing of Pelvic Support Mechanisms. Ochsner J., 2020; 20(4): 410–418.
13. DELANCEY JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol., 1992; 166(6): 1717-1724.
14. DWYER L, et al. What is known from the existing literature about self-management of pessaries for pelvic organ prolapse? A scoping review. BMJ Open., 2022; 12(1): e055587.
15. ENIKEEV ME, et al. Repair of cystocele and apical genital prolapse using 6-strap mesh implant. Urologia, 2020; 87(3): 130-136.
16. FIGUEIRÊDO-NETTO O, et al. Colpopexia sacroespinhal: análise de sua aplicação em portadoras de prolapso uterovaginal e de cúpula vaginal pós-histerectomia. Rev. Bras. Gine Obstet., 2004; 26(10): 1-5.
17. FERNANDES ACN, et al. Conservative non-pharmacological interventions in women with pelvic floor dysfunction: a systematic review of qualitative studies. BMC Womens Health, 2022; 22(1): e515.
18. GHANBARI Z, et al. Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis. J Clin Med., 2022; 11(23): 7166.
19. HAYLEN BT, et al. Erratum to: An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016; 27(2): 165-94.
20. KAMIńSKA A, et al. Reliability of the Polish Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Assessment of Sexual Function before and after Pelvic Organ Prolapse Reconstructive Surgery—A Prospective Study. J Clin Med., 2021; 10(18): e4167.
21. LASNEL MM, et al. Patient satisfaction and symptom changes in women using a pessary for pelvic organ prolapse. Prog Urol, 2020; 30(7): 381-389.
22. LINDER BJ, et al. Comparison of outcomes between pessary use and surgery for symptomatic pelvic organ prolapse: A prospective self-controlled study. Investig Clin Urol., 2022; 63(2): 214-220.
23. LONG J, et al. An estriol-eluting pessary to treat pelvic organ prolapse. Sci Rep., 2022; 12(1): e20021.
24. MANZINI C, et al. Parameters associated with unsuccessful pessary fitting for pelvic organ prolapse up to three months follow-up: a systematic review and meta-analysis. Int Urogynecol J., 2022; 33(7): 1719-1763.
25. MAO M, et al. Factors associated with long-term pessary use in women with symptomatic pelvic organ prolapse. Climacteric, 2019; 22(5): 478-482.
26. MCNEILL ER, et al. The impact on complication rates of delayed routine pessary reviews during the COVID-19 pandemic. Int Urogynecol J., 2022; 22(1): 1-7.
27. MELKIE TB, et al. Translation, reliability, and validity of Amharic versions of the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). PLoS One, 2022; 17(11): e0270434.
28. NEBEL S, et al. How Satisfied Are Women 6 Months after a Pessary Fitting for Pelvic Organ Prolapse? J Clin Med., 2022; 11(19): e5972.
29. NEMETH Z, et al. Self-management of vaginal cube pessaries may be a game changer for pelvic organ prolapse treatment: a long-term follow-up study. Int Urogynecol J., 2022; 22(1): 1–7.
30. ONTARIO HEALTH. Vaginal Pessaries for Pelvic Organ Prolapse or Stress Urinary Incontinence: A Health Technology Assessment. Ont Health Technol Assess Ser. 2021; 21(3): 1-155.
31. OLIVER R, et al. A The history and usage of the vaginal pessary: a review. ejog, 2011; 156(2): 125-130.
32. PRADO DS, et al. Avaliação do impacto da correção cirúrgica de distopias genitais sobre a função sexual feminina. Rev Bras Ginecol Obstet., 2007; 29(10): 519-524.
33. OLIVEIRA MS, et al. Validation of the Prolapse Quality-of-Life Questionnaire (P-QoL) in Portuguese version in Brazilian women. Tese, Universidade de São Paulo, 2017: 1-138. Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20(10): 1191-202.
34. RADNIA N, et al. Patient Satisfaction and Symptoms Improvement in Women Using a Vginal Pessary for The Treatment of Pelvic Organ Prolapse. J Med Life., 2019; 12(3): 271–275.
35. RODRIGUES AM, et al. Fatores de risco para o prolapso genital em uma população brasileira. Rev Bras Ginecol Obstet. 2009; 31(1):17-21.
36. SÁNCHEZ-SÁNCHEZ B, et al. Quality of Life in POP: Validity, Reliability and Responsiveness of the Prolapse Quality of Life Questionnaire (P-QoL) in Spanish Women. Int J Environ Res Public Health., 2020; 17(5): e1690.
37. THYS S, et al. Can we predict continued pessary use as primary treatment in women with symptomatic pelvic organ prolapse (POP)? A prospective cohort study. Int Urogynecol J, 2021; 32(8): 2159-2167.
38. VAART LRVD, et al. Female Sexual Functioning in Women With a Symptomatic Pelvic Organ Prolapse; A Multicenter Prospective Comparative Study Between Pessary and Surgery. J Sex Med, 2022; 19(2): 270-2792.
39. XU H, et al. A predictive model of choosing pessary type for women with symptomatic pelvic organ prolapse. Menopause., 2021; 28(11): 1279–1286.
40. YANG J, et al. Ring and Gellhorn pessaries used in patients with pelvic organ prolapse: a retrospective study of 8 years. RCH Gynecol Obstet, 2018; 298(3): 623–629.
41. ZEIGER BB, et al. Vaginal pessary in advanced pelvic organ prolapse: impact on quality of life. Int Urogynecol J., 2022; 33(7): 2013–2020.
42. ZIV E e ERLICH E. Novel, disposable, self-inserted, vaginal device for the non-surgical management of pelvic organ prolapse: efficacy, safety, and quality of life. BMC Womens Health., 2022; 22(1): 459.
2. BELAYNEH T, et al. Pelvic organ prolapse surgery and health-related quality of life: a follow-up study. BMC Womens Health., 2021; 21(1): 1-4.
3. BODNER-ADLER B, et al. Prolapse surgery versus vaginal pessary in women with symptomatic pelvic organ prolapse: which factors influence the choice of treatment? Arch Gynecol Obstet. 2019; 299(3): 773–777.
4. BRANDT C e VUUREN ECJV. Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse. S Afr J Physiother. 2019; 75(1): e933.
5. BROWN L, et al. Defining patient knowledge and perceptions of vaginal pessaries for prolapse and incontinence. Female Pelvic Med Reconstr Surg., 2016; 22(2): 93-97.
6. BUGGE C, et al. Pessaries (mechanical devices) for managing pelvic organ prolapse in women. Cochrane Database Syst Rev., 2020; 11(11): CD004010.
7. BUMP RC, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol, 1996; 175(1): 10-17.
8. CARRAMÃO S, et al. Estudo randômico da correção cirúrgica do prolapso uterino através de tela sintética de polipropileno tipo I comparando histerectomia versus preservação uterina. Rev. Col. Bras. Cir., 2009; 36(1): 65-72.
9. CARROLL L, et al. Pelvic organ prolapse: The lived experience. PLoS One., 2022; 17(11): e0276788.
10. COELHO SA, et al. Factors associated with the prescription of vaginal pessaries for pelvic organ prolapse. Clínicas (São Paulo), 2019; 74(1): e934.
11. COELHO S, et al. Quality of life and vaginal symptoms of postmenopausal women using pessary for pelvic organ prolapse: a prospective study. Rev Assoc Med Bra. 2018; 64(12): 1103-1107.
12. CONWAY CK, et al. Pelvic Organ Prolapse: A Review of In Vitro Testing of Pelvic Support Mechanisms. Ochsner J., 2020; 20(4): 410–418.
13. DELANCEY JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol., 1992; 166(6): 1717-1724.
14. DWYER L, et al. What is known from the existing literature about self-management of pessaries for pelvic organ prolapse? A scoping review. BMJ Open., 2022; 12(1): e055587.
15. ENIKEEV ME, et al. Repair of cystocele and apical genital prolapse using 6-strap mesh implant. Urologia, 2020; 87(3): 130-136.
16. FIGUEIRÊDO-NETTO O, et al. Colpopexia sacroespinhal: análise de sua aplicação em portadoras de prolapso uterovaginal e de cúpula vaginal pós-histerectomia. Rev. Bras. Gine Obstet., 2004; 26(10): 1-5.
17. FERNANDES ACN, et al. Conservative non-pharmacological interventions in women with pelvic floor dysfunction: a systematic review of qualitative studies. BMC Womens Health, 2022; 22(1): e515.
18. GHANBARI Z, et al. Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis. J Clin Med., 2022; 11(23): 7166.
19. HAYLEN BT, et al. Erratum to: An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016; 27(2): 165-94.
20. KAMIńSKA A, et al. Reliability of the Polish Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Assessment of Sexual Function before and after Pelvic Organ Prolapse Reconstructive Surgery—A Prospective Study. J Clin Med., 2021; 10(18): e4167.
21. LASNEL MM, et al. Patient satisfaction and symptom changes in women using a pessary for pelvic organ prolapse. Prog Urol, 2020; 30(7): 381-389.
22. LINDER BJ, et al. Comparison of outcomes between pessary use and surgery for symptomatic pelvic organ prolapse: A prospective self-controlled study. Investig Clin Urol., 2022; 63(2): 214-220.
23. LONG J, et al. An estriol-eluting pessary to treat pelvic organ prolapse. Sci Rep., 2022; 12(1): e20021.
24. MANZINI C, et al. Parameters associated with unsuccessful pessary fitting for pelvic organ prolapse up to three months follow-up: a systematic review and meta-analysis. Int Urogynecol J., 2022; 33(7): 1719-1763.
25. MAO M, et al. Factors associated with long-term pessary use in women with symptomatic pelvic organ prolapse. Climacteric, 2019; 22(5): 478-482.
26. MCNEILL ER, et al. The impact on complication rates of delayed routine pessary reviews during the COVID-19 pandemic. Int Urogynecol J., 2022; 22(1): 1-7.
27. MELKIE TB, et al. Translation, reliability, and validity of Amharic versions of the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). PLoS One, 2022; 17(11): e0270434.
28. NEBEL S, et al. How Satisfied Are Women 6 Months after a Pessary Fitting for Pelvic Organ Prolapse? J Clin Med., 2022; 11(19): e5972.
29. NEMETH Z, et al. Self-management of vaginal cube pessaries may be a game changer for pelvic organ prolapse treatment: a long-term follow-up study. Int Urogynecol J., 2022; 22(1): 1–7.
30. ONTARIO HEALTH. Vaginal Pessaries for Pelvic Organ Prolapse or Stress Urinary Incontinence: A Health Technology Assessment. Ont Health Technol Assess Ser. 2021; 21(3): 1-155.
31. OLIVER R, et al. A The history and usage of the vaginal pessary: a review. ejog, 2011; 156(2): 125-130.
32. PRADO DS, et al. Avaliação do impacto da correção cirúrgica de distopias genitais sobre a função sexual feminina. Rev Bras Ginecol Obstet., 2007; 29(10): 519-524.
33. OLIVEIRA MS, et al. Validation of the Prolapse Quality-of-Life Questionnaire (P-QoL) in Portuguese version in Brazilian women. Tese, Universidade de São Paulo, 2017: 1-138. Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20(10): 1191-202.
34. RADNIA N, et al. Patient Satisfaction and Symptoms Improvement in Women Using a Vginal Pessary for The Treatment of Pelvic Organ Prolapse. J Med Life., 2019; 12(3): 271–275.
35. RODRIGUES AM, et al. Fatores de risco para o prolapso genital em uma população brasileira. Rev Bras Ginecol Obstet. 2009; 31(1):17-21.
36. SÁNCHEZ-SÁNCHEZ B, et al. Quality of Life in POP: Validity, Reliability and Responsiveness of the Prolapse Quality of Life Questionnaire (P-QoL) in Spanish Women. Int J Environ Res Public Health., 2020; 17(5): e1690.
37. THYS S, et al. Can we predict continued pessary use as primary treatment in women with symptomatic pelvic organ prolapse (POP)? A prospective cohort study. Int Urogynecol J, 2021; 32(8): 2159-2167.
38. VAART LRVD, et al. Female Sexual Functioning in Women With a Symptomatic Pelvic Organ Prolapse; A Multicenter Prospective Comparative Study Between Pessary and Surgery. J Sex Med, 2022; 19(2): 270-2792.
39. XU H, et al. A predictive model of choosing pessary type for women with symptomatic pelvic organ prolapse. Menopause., 2021; 28(11): 1279–1286.
40. YANG J, et al. Ring and Gellhorn pessaries used in patients with pelvic organ prolapse: a retrospective study of 8 years. RCH Gynecol Obstet, 2018; 298(3): 623–629.
41. ZEIGER BB, et al. Vaginal pessary in advanced pelvic organ prolapse: impact on quality of life. Int Urogynecol J., 2022; 33(7): 2013–2020.
42. ZIV E e ERLICH E. Novel, disposable, self-inserted, vaginal device for the non-surgical management of pelvic organ prolapse: efficacy, safety, and quality of life. BMC Womens Health., 2022; 22(1): 459.