{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:50:14Z","timestamp":1791881414136,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the anatomical effect of pessaries in the upright position in women with pelvic organ prolapse (POP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Outpatient clinic of our gynaecology department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Fifteen POP patients with successful ring\u2010shaped pessary use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Upright magnetic resonance (MR) images of the pelvis were acquired before, immediately after insertion of their pessaries, and 1\u2009week later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Distances from the lowest points of the bladder, cervix, and pessary to the pelvic inclination correction system (PICS) line were measured, as well as the angles of the uterus and pessary relative to the PICS in the midsagittal plane.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pessary insertion lifted the bladder's lowest point from 0.1\u2009cm below to 0.6\u2009cm above the PICS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), but it descended to 0.2\u2009cm above the PICS 1\u2009week later (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.334). The cervix was lifted from 0.0 to 2.5\u2009cm above the PICS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), which persisted after 1\u2009week (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.470). The angle between uterus and PICS increased after insertion from 97\n                      <jats:sup>o<\/jats:sup>\n                      to 115\n                      <jats:sup>o<\/jats:sup>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and remained stable (113\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.198). Pessary position changed from 0.7 to 0.3\u2009cm below the PICS in 1\u2009week (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020); the angle did not change (56\u00b0 to 54\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.820).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pessary insertion changes the pelvic organ position and angulation. After an initial lift, the effect on the bladder diminished after 1\u2009week, while for the uterus it remained. This may suggest a role for uterus lift in relieving POP symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70280","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:01:22Z","timestamp":1781586082000},"page":"2151-2158","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Pessary Insertion on Pelvic Anatomy: A Prospective Observational Study Using Upright\n                    <scp>MRI<\/scp>"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8645-7586","authenticated-orcid":false,"given":"Annemarie van der","family":"Steen","sequence":"first","affiliation":[{"name":"Department of Gynecology Ziekenhuisgroep Twente  Hengelo the Netherlands"},{"name":"Multi\u2010Modality Medical Imaging (M3i) Group, Technical Medical Centre University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimy A.","family":"Simmering","sequence":"additional","affiliation":[{"name":"Department of Gynecology Ziekenhuisgroep Twente  Hengelo the Netherlands"},{"name":"Multi\u2010Modality Medical Imaging (M3i) Group, Technical Medical Centre University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Perik","sequence":"additional","affiliation":[{"name":"Department of Gynecology Ziekenhuisgroep Twente  Hengelo the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank F. J.","family":"Simonis","sequence":"additional","affiliation":[{"name":"Magnetic Detection and Imaging (MD&amp;I), TechMed Centre University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frieda van den","family":"Noort","sequence":"additional","affiliation":[{"name":"Multi\u2010Modality Medical Imaging (M3i) Group, Technical Medical Centre University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anique T. M.","family":"Grob","sequence":"additional","affiliation":[{"name":"Department of Gynecology Ziekenhuisgroep Twente  Hengelo the Netherlands"},{"name":"Multi\u2010Modality Medical Imaging (M3i) Group, Technical Medical Centre University of Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.08.070"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010020\u201005526\u20101"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24477"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.15260"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.08.034"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201081985\u20109"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010021\u201005053\u2010w"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2009.02380.x"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2482070974"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010023\u201005555\u20109"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010024\u201005802\u20107"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010025\u201006182\u20102"},{"key":"e_1_2_14_14_1","unstructured":"\u201cExpert Opinion: Vaginal Pessaries in the Management of Pelvic Organ Prolapse \u201dhttps:\/\/www.iuga.org\/spotlight\u2010v16\u20101\/expert\u2010opinion\u2010vaginal\u2010pessaries\u2010in\u2010the\u2010management\u2010of\u2010pelvic\u2010organ\u2010prolapse."},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2012.05.001"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010022\u201005289\u20100"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compmedimag.2017.05.005"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010023\u201005550\u20100"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.spv.0000240144.83553.d2"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.05.012"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010018\u201003862\u20100"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.01.047"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003300051028"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13164819"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.21232"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010021\u201005015\u20102"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.125733"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AJOG.2006.06.065"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109378(92)91562\u2010O"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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