Continence pessaries in the management of urinary incontinence in women.

Objective: To evaluate the effectiveness of continence pessaries for the management of urinary incontinence in women.

Methods: A retrospective review of the records of 100 women who chose to try a pessary to treat their urinary incontinence. Demographic data, presenting symptoms, physical findings, results of objective testing (pad tests and urodynamics), and incontinence outcomes were abstracted. Factors such as age, pelvic prolapse, presenting symptoms, pessary type, and history of previous incontinence surgery were examined using the Student t-test, chi-square test, or Fisher exact test where appropriate.

Results: The mean age of the women was 56 years (range, 28-86 years) and mean parity was 2.5 (range, 0-13). Presenting complaints included stress incontinence in 41 women, mixed incontinence in 53 women, urge incontinence in 3 women, and combined prolapse and incontinence in 3 women. All 100 women returned for follow-up visits. Forty women had their pessary size or type adjusted at the first follow-up visit. At a mean follow-up time of 11 months (range, 2-42 months), 59 women continued to experience a complete resolution or decrease in their incontinence and chose to continue use of a pessary. Age, presenting symptoms, degree of pelvic prolapse, and type of pessary did not affect the success of pessary treatment. Women who had undergone incontinence surgery prior to pessary fitting had a higher failure rate, with relative risk (RR) of 1.6.

Conclusion: Urinary incontinence pessaries are effective. More than 50% of women who try a continence pessary will continue to use it to manage their urinary incontinence.