IMPORTANCE There is currently a paucity of data describing the outcomes of women with pelvic organ prolapse (POP) and/or urinary incontinence (UI) who present with pessary-related complications. OBJECTIVE This study aimed to describe outcomes in women with POP and UI managed with a pessary who present with pessary-related complications. STUDY DESIGN This was a retrospective cohort study of women with POP and/or UI who elected for management with a pessary from January 1, 2016, to December 31, 2020. Patients were included if they had used a pessary for at least 1 year and had a documented pessary-related complication. Complications were defined a priori, and patient charts were abstracted using International Classification of Diseases, Ninth and Tenth Revisions codes associated with pessary use. RESULTS Of 2,088 of women receiving pessary care, 444 (21%) experienced a complication. Of 154 of women, 34.6% experienced 2 pessary-related complications during the study period, whereas 12.6% (56) experienced 3, 4.5% (20) experienced 4, and 1.8% (8) experienced 5. One hundred fifty-two patients (34.2%) underwent surgery during the study period to manage their POP and/or UI. Patients who were older were less likely to have surgery (adjusted odds ratio, 0.70 [95% confidence interval, 0.20-0.90]; P = 0.002), and patients who had an indication of pessary use for both POP and UI were more likely to undergo surgery during the study period (adjusted odds ratio, 2.12 [95% confidence interval, 1.29-3.48]; P = 0.003). CONCLUSIONS Our results suggest that 1 in 5 patients has a documented complication associated with pessary use of greater than 1 year. Of these patients, one third will eventually undergo surgery for management of their POP and/or UI.

中文翻译：

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患有盆腔器官脱垂并伴有子宫托相关并发症的女性的结果。

重要性 目前，缺乏描述患有盆腔器官脱垂 (POP) 和/或尿失禁 (UI) 且出现子宫托相关并发症的女性结局的数据。目的 本研究旨在描述使用子宫托治疗 POP 和 UI 且出现子宫托相关并发症的女性的结局。研究设计 这是一项回顾性队列研究，对象为 2016 年 1 月 1 日至 2020 年 12 月 31 日期间选择使用子宫托进行治疗的 POP 和/或 UI 女性。如果患者使用子宫托至少 1 年且有记录的子宫托相关并发症。预先定义并发症，并使用国际疾病分类、与子宫托使用相关的第九版和第十版修订代码提取患者图表。结果 在 2,088 名接受子宫托护理的女性中，444 名 (21%) 出现了并发症。在 154 名女性中，34.6% 在研究期间经历了 2 种子宫托相关并发症，而 12.6% (56) 经历了 3 种、4.5% (20) 经历了 4 种、1.8% (8) 经历了 5 种。 152 名患者(34.2%) 在研究期间接受了手术来控制 POP 和/或 UI。年龄较大的患者接受手术的可能性较小（调整后的比值比，0.70 [95% 置信区间，0.20-0.90]；P = 0.002），而有 POP 和 UI 均使用子宫托指征的患者更有可能接受手术在研究期间接受手术（调整后的比值比，2.12 [95% 置信区间，1.29-3.48]；P = 0.003）。结论 我们的结果表明，五分之一的患者有记录的与子宫托使用超过一年相关的并发症。在这些患者中，三分之一最终将接受手术来治疗 POP 和/或 UI。