Table 4.
Studies reporting adverse outcomes with long-term pessary use (without removal and cleaning)
| Outcome | Study | Pubmed ID | Country | Pessary type | Duration (months) | Outcome definition | n/N (%) |
|---|---|---|---|---|---|---|---|
| Discharge | Cheung 2016 | 27,275,798 | China | Ring | 6 | Unusual or bothersome discharge | 6/132 (4.5%) |
| Miceli 2020 | 32,062,679 | Spain | Ring | 24 | Increase in vaginal discharge | 6/115 (5.2%) | |
| Chien 2019 | 31,393,340 | Taiwan | Gellhorn |
12–111 (mean 50.4) |
Abnormal vaginal discharge | 8/93 (8.6%) | |
| Erosion | Propst 2020 | 31,809,432 | USA | Multiple | 3 | Type 3 or 4 (epithelial break or erosion) | 4/54 (7.4%) |
| Thys 2020 | 31,907,565 | USA | Ring | 3 | Lesion of the vaginal epithelium | 0/132 (0%) | |
| Tam 2019 | 31,561,819 | Hong Kong | Ring | 3 | Ulceration or erosion | 1/29 (3.4%) | |
| Propst 2020 | 31,809,432 | USA | Multiple | 6 | Type 3 or 4 (epithelial break or erosion) | 1/57 (1.8%) | |
| Lone 2011 | 21,575,953 | UK | Multiple | 6 | Discontinue use because of excoriation or bleeding | 5/223 (2.2%) | |
| Tam 2019 | 31,561,819 | Hong Kong | Ring | 6 | Ulceration or erosion | 6/30 (20%) | |
| Cheung 2016 | 27,275,798 | China | Ring | 6 | Abnormal vaginal bleeding | 9/132 (6.8%) | |
| Miceli 2020 | 32,062,679 | Spain | Ring | 24 | Vaginal bleeding/erosion | 8/115 (7.0%) | |
| Chien 2019 | 31,393,340 | Taiwan | Gellhorn |
12–111 (mean 50.4) |
Vaginal bleeding/erosion | 9/93 (9.71%) | |
| Fistula | Propst 2020 | 31,809,432 | USA | Multiple | 3 | Fistula | 0/54 (0%) |
| Tam 2019 | 31,561,819 | Hong Kong | Ring | 3 | Fistula | 0/29 (0%) | |
| Thys 2020 | 31,907,565 | USA | Ring | 3 | Fistula | 0/132 (0%) | |
| Propst 2020 | 31,809,432 | USA | Multiple | 6 | Fistula | 0/57 (0%) | |
| Tam 2019 | 31,561,819 | Hong Kong | Ring | 6 | Fistula | 0/30 (0%) | |
| Lone 2011 | 21,575,953 | UK | Multiple | 6 | Fistula | 0/223 (0%) | |
| Miceli 2020 | 32,062,679 | Spain | Ring | 24 | Major complication | 0/115 (0%) | |
| Chien 2019 | 31,393,340 | Taiwan | Gellhorn |
12–111 (mean 50.4) |
Fistula | 0/93 (0%) | |
| Retention | Tam 2019 | 31,561,819 | Hong Kong | Ring | 3 | Urinary retention | 0/29 (0%) |
| Tam 2019 | 31,561,819 | Hong Kong | Ring | 6 | Urinary retention | 0/30 (0%) | |
| Cheung 2016 | 27,275,798 | China | Ring | 6 | Voiding difficulty, de novo | 10/92 (10.9%) | |
| Chien 2019 | 31,393,340 | Taiwan | Gellhorn |
12–111 (mean 50.4) |
Voiding/defecating difficulty | 4/93 (4.3%) | |
| Vaginitis | Tam 2019 | 31,561,819 | Hong Kong | Ring | 3 | Vaginitis | 0/29 (0%) |
| Cheung 2016 | 27,275,798 | China | Ring | 6 | Bacterial vaginosis | 1/132 (0.8%) | |
| Tam 2019 | 31,561,819 | Hong Kong | Ring | 6 | Vaginitis | 3/30 (10%) | |
| Miceli 2020 | 32,062,679 | Spain | Ring | 24 | Candida glabrata | 1/115 (0.9%) |