{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T23:21:49Z","timestamp":1772925709368,"version":"3.50.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T00:00:00Z","timestamp":1691193600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T00:00:00Z","timestamp":1691193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018609","name":"High-level Hospital Construction Project of Guangdong Provincial People's Hospital","doi-asserted-by":"publisher","award":["No. 2022-PUMCH-C-031"],"award-info":[{"award-number":["No. 2022-PUMCH-C-031"]}],"id":[{"id":"10.13039\/501100018609","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and hypothesis<\/jats:title>\n                <jats:p>The objective was to evaluate the efficacy of pessaries in the treatment of stage IV pelvic organ prolapse (POP) and identify the influencing factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>One hundred and fifty-seven patients with stage IV symptomatic POP were admitted to the hospital for pessary fitting. A successful pessary fitting was defined as a patient fitted with a pessary at the initial fitting in whom use continued 2\u00a0weeks later. The rates of successful pessary fitting, patient satisfaction, remission of prolapse and urinary symptoms, and the occurrence of factors associated with successful pessary fitting were calculated and predictors of appropriate pessary type selection were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 130 patients with stage IV POP had a successful pessary fitting (82.8%). The satisfaction rate associated with the two types of pessaries was more than 90%. The success rate among patients undergoing a ring pessary fitting trial was 44.6%, and 84.3% of the patients were self-managed. Prolapse symptoms significantly improved in 90% of cases, and urinary symptoms improved in 58\u201393% of cases from baseline. The number of vaginal deliveries, history of hysterectomy and vaginal introitus\/total vaginal length (TVL) ratio were independent risk factors associated with unsuccessful pessary fitting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>For patients with stage IV POP, the successful fitting rate is as high as 80% or more. More vaginal deliveries, a history of hysterectomy, and a larger vaginal introitus\/TVL ratio (ratio \u2009&gt;0.6) were predictors of unsuccessful pessary fitting.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-023-05594-2","type":"journal-article","created":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T10:01:52Z","timestamp":1691229712000},"page":"59-67","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes of pessary fitting trials for patients with stage IV pelvic organ prolapse: a prospective study"],"prefix":"10.1007","volume":"35","author":[{"given":"Ying","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianshu","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aijing","family":"Ju","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5753-5426","authenticated-orcid":false,"given":"Lan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,5]]},"reference":[{"issue":"4","key":"5594_CR1","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1097\/gme.0b013e3181967b5d","volume":"16","author":"L Zhu","year":"2009","unstructured":"Zhu L, Lang J, Liu C, Han S, Huang J, Li X. The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China. Menopause. 2009;16(4):831\u20136. https:\/\/doi.org\/10.1097\/gme.0b013e3181967b5d.","journal-title":"Menopause"},{"issue":"5","key":"5594_CR2","doi-asserted-by":"publisher","first-page":"300","DOI":"10.3760\/cma.j.cn112141-20200106-00016","volume":"55","author":"Chinese Society of Gynecology and Obstetrics and Gynecology","year":"2020","unstructured":"Chinese Society of Gynecology and Obstetrics and Gynecology. Guidelines for diagnosis and treatment of pelvic organ prolapse in China (Version 2020). Chin J Obstet Gynecol. 2020;55(5):300\u20136. https:\/\/doi.org\/10.3760\/cma.j.cn112141-20200106-00016.","journal-title":"Chin J Obstet Gynecol"},{"issue":"9","key":"5594_CR3","first-page":"1111","volume":"81","author":"I Kuncharapu","year":"2010","unstructured":"Kuncharapu I, Majeroni BA, Johnson DW. Pelvic organ prolapse. Am Fam Physician. 2010;81(9):1111\u20137.","journal-title":"Am Fam Physician"},{"issue":"2","key":"5594_CR4","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jmwh.2005.09.003","volume":"51","author":"JM Maito","year":"2006","unstructured":"Maito JM, Quam ZA, Craig E, Danner KA, Rogers RG. Predictors of successful pessary fitting and continued use in a nurse-midwifery pessary clinic. J Midwifery Womens Health. 2006;51(2):78\u201384. https:\/\/doi.org\/10.1016\/j.jmwh.2005.09.003.","journal-title":"J Midwifery Womens Health"},{"issue":"1","key":"5594_CR5","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.ajog.2004.12.012","volume":"193","author":"MF Mutone","year":"2005","unstructured":"Mutone MF, Terry C, Hale DS, Benson JT. Factors which influence the short-term success of pessary management of pelvic organ prolapse. Am J Obstet Gynecol. 2005;193(1):89\u201394. https:\/\/doi.org\/10.1016\/j.ajog.2004.12.012.","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"5594_CR6","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1097\/00152192-200507000-00010","volume":"32","author":"JN Nguyen","year":"2005","unstructured":"Nguyen JN, Jones CR. Pessary treatment of pelvic relaxation: factors affecting successful fitting and continued use. J Wound Ostomy Continence Nurs. 2005;32(4):255\u2013261; quiz 262\u2013253. https:\/\/doi.org\/10.1097\/00152192-200507000-00010.","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"5","key":"5594_CR7","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1007\/s00192-016-3184-4","volume":"28","author":"Z Nemeth","year":"2017","unstructured":"Nemeth Z, Farkas N, Farkas B. Is hysterectomy or prior reconstructive surgery associated with unsuccessful initial trial of pessary fitting in women with symptomatic pelvic organ prolapse? Int Urogynecol J. 2017;28(5):757\u201361. https:\/\/doi.org\/10.1007\/s00192-016-3184-4.","journal-title":"Int Urogynecol J"},{"issue":"5","key":"5594_CR8","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/SPV.0b013e31822f00ae","volume":"17","author":"D Markle","year":"2011","unstructured":"Markle D, Skoczylas L, Goldsmith C, Noblett K. Patient characteristics associated with a successful pessary fitting. Female Pelvic Med Reconstr Surg. 2011;17(5):249\u201352. https:\/\/doi.org\/10.1097\/SPV.0b013e31822f00ae.","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"6","key":"5594_CR9","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1097\/SPV.0b013e3182a26174","volume":"19","author":"R Geoffrion","year":"2013","unstructured":"Geoffrion R, Zhang T, Lee T, Cundiff GW. Clinical characteristics associated with unsuccessful pessary fitting outcomes. Female Pelvic Med Reconstr Surg. 2013;19(6):339\u201345. https:\/\/doi.org\/10.1097\/SPV.0b013e3182a26174.","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"1","key":"5594_CR10","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1097\/01.AOG.0000222903.38684.cc","volume":"108","author":"RJ Fernando","year":"2006","unstructured":"Fernando RJ, Thakar R, Sultan AH, Shah SM, Jones PW. Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse. Obstet Gynecol. 2006;108(1):93\u20139. https:\/\/doi.org\/10.1097\/01.AOG.0000222903.38684.cc.","journal-title":"Obstet Gynecol"},{"issue":"11","key":"5594_CR11","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1111\/1471-0528.15260","volume":"125","author":"M Mao","year":"2018","unstructured":"Mao M, Ai F, Zhang Y, et al. Predictors for unsuccessful pessary fitting in women with symptomatic pelvic organ prolapse: a prospective study. BJOG. 2018;125(11):1434\u201340. https:\/\/doi.org\/10.1111\/1471-0528.15260.","journal-title":"BJOG"},{"issue":"2","key":"5594_CR12","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.ajog.2003.08.034","volume":"190","author":"JL Clemons","year":"2004","unstructured":"Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL. Risk factors associated with an unsuccessful pessary fitting trial in women with pelvic organ prolapse. Am J Obstet Gynecol. 2004;190(2):345\u201350. https:\/\/doi.org\/10.1016\/j.ajog.2003.08.034.","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"5594_CR13","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s00404-010-1675-y","volume":"284","author":"T Manchana","year":"2011","unstructured":"Manchana T. Ring pessary for all pelvic organ prolapse. Arch Gynecol Obstet. 2011;284(2):391\u20135. https:\/\/doi.org\/10.1007\/s00404-010-1675-y.","journal-title":"Arch Gynecol Obstet"},{"issue":"7","key":"5594_CR14","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1007\/s00192-021-05015-2","volume":"33","author":"C Manzini","year":"2022","unstructured":"Manzini C, Morsinkhof LM, van der Vaart CH, Withagen MIJ, Grob ATM. 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\u201363. https:\/\/doi.org\/10.1007\/s00192-021-05015-2.","journal-title":"Int Urogynecol J"},{"issue":"10","key":"5594_CR15","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1007\/s00192-015-2738-1","volume":"26","author":"J Ding","year":"2015","unstructured":"Ding J, Chen C, Song XC, Zhang L, Deng M, Zhu L. Successful use of ring pessary with support for advanced pelvic organ prolapse. Int Urogynecol J. 2015;26(10):1517\u201323. https:\/\/doi.org\/10.1007\/s00192-015-2738-1.","journal-title":"Int Urogynecol J"},{"issue":"10","key":"5594_CR16","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1007\/s00192-009-0930-x","volume":"20","author":"DS Kapoor","year":"2009","unstructured":"Kapoor DS, Thakar R, Sultan AH, Oliver R. Conservative versus surgical management of prolapse: what dictates patient choice? Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(10):1157\u201361. https:\/\/doi.org\/10.1007\/s00192-009-0930-x.","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"issue":"8","key":"5594_CR17","doi-asserted-by":"publisher","first-page":"2238","DOI":"10.1002\/nau.24477","volume":"39","author":"C Ma","year":"2020","unstructured":"Ma C, Xu T, Kang J, et al. Factors associated with pessary fitting in women with symptomatic pelvic organ prolapse: a large prospective cohort study. Neurourol Urodyn. 2020;39(8):2238\u201345. https:\/\/doi.org\/10.1002\/nau.24477.","journal-title":"Neurourol Urodyn"},{"issue":"8","key":"5594_CR18","doi-asserted-by":"publisher","first-page":"2344","DOI":"10.1002\/nau.24493","volume":"39","author":"CTM Vasconcelos","year":"2020","unstructured":"Vasconcelos CTM, Gomes MLS, Geoffrion R, Saboia DM, Bezerra KC, Vasconcelos Neto JA. Pessary evaluation for genital prolapse treatment: from acceptance to successful fitting. Neurourol Urodyn. 2020;39(8):2344\u201352. https:\/\/doi.org\/10.1002\/nau.24493.","journal-title":"Neurourol Urodyn"},{"issue":"9","key":"5594_CR19","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1007\/s00192-009-0866-1","volume":"20","author":"CW Nager","year":"2009","unstructured":"Nager CW, Richter HE, Nygaard I, et al. Incontinence pessaries: size, POPQ measures, and successful fitting. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1023\u20138. https:\/\/doi.org\/10.1007\/s00192-009-0866-1.","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"issue":"7","key":"5594_CR20","doi-asserted-by":"publisher","first-page":"1912","DOI":"10.1002\/nau.24458","volume":"39","author":"SC de Albuquerque Coelho","year":"2020","unstructured":"de Albuquerque Coelho SC, Brito LGO, de Araujo CC, Juliato CRT. Factors associated with unsuccessful pessary fitting in women with symptomatic pelvic organ prolapse: systematic review and metanalysis. Neurourol Urodyn. 2020;39(7):1912\u201321. https:\/\/doi.org\/10.1002\/nau.24458.","journal-title":"Neurourol Urodyn"},{"issue":"12","key":"5594_CR21","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1007\/s00192-016-3051-3","volume":"27","author":"J Ding","year":"2016","unstructured":"Ding J, Song XC, Deng M, Zhu L. Which factors should be considered in choosing pessary type and size for pelvic organ prolapse patients in a fitting trial? Int Urogynecol J. 2016;27(12):1867\u201371. https:\/\/doi.org\/10.1007\/s00192-016-3051-3.","journal-title":"Int Urogynecol J"},{"issue":"4","key":"5594_CR22","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1097\/AOG.0b013e31824c0806","volume":"119","author":"PJ Culligan","year":"2012","unstructured":"Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstet Gynecol. 2012;119(4):852\u201360. https:\/\/doi.org\/10.1097\/AOG.0b013e31824c0806.","journal-title":"Obstet Gynecol"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-023-05594-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-023-05594-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-023-05594-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T14:24:11Z","timestamp":1706192651000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-023-05594-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,5]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["5594"],"URL":"https:\/\/doi.org\/10.1007\/s00192-023-05594-2","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,5]]},"assertion":[{"value":"23 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This research has not been published previously, and it is not under consideration for publication elsewhere.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Submission"}}]}}