How Often Should Office Visits for Pessary Care Happen?

Vaginal pessaries represent a common, effective therapy for pelvic organ prolapse and stress urinary incontinence; however, vaginal mucosal erosions can complicate pessary use — and risk for erosions is likely affected by frequency with which the pessary is removed, cleaned, and reinserted. Investigators at a single U.S. hospital conducted a randomized trial involving women who were ongoing users of ring, incontinence dish, or Gelhorn pessaries; did not change their pessaries by themselves; and had no vaginal mucosal abnormalities. In all, 130 participants (mean age, 79; 91% white, 5% black, 4% Hispanic; 74% using vaginal estrogen) were assigned to routine care (office visits for pessary changes every 12 weeks) or extended care (every 24 we…