{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T20:00:46Z","timestamp":1765742446397},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T00:00:00Z","timestamp":1584489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Continuous usage of a ring pessary for pelvic organ prolapse may cause a disturbance of intravaginal microbiota and intravaginal mucosal damage. To avoid the side effects of continuous ring pessary therapy, daily self\u2010replacement of the ring pessary is recommended. The purpose of this study is to evaluate the outcomes of self\u2010replacement versus continuous ring usage, by analysing clinical findings and intravaginal microbiota.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty seven patients who managed self\u2010replacement ring pessary therapy and 13 patients with continuous ring pessary therapy participated in this study. The clinical symptoms were checked at 1\u2009month after the initial ring pessary insertion. The changes in the intravaginal microbiota were evaluated by conventional methods, i.e. pH in the vagina, Lactobacillary grade, Nugent score, inflammatory cell counts, and culture\u2010based bacterial detection methods. In addition, our clone library method using 16S rRNA sequencing of vaginal fluid was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients were divided into four groups: self\u2010replacement pre\/post\u2010menopause and continuous and pre\/post\u2010menopause. Five patients of the self\u2010replacement group (<jats:italic>n<\/jats:italic> = 37) and all patients of the continuous use group (<jats:italic>n<\/jats:italic> = 13) complained of increased discharge. However, both the conventional methods and the clone library method revealed that the number of the self\u2010replacement group patients who had abnormal intravaginal microbiota were not significantly different from that of the continuous use group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Daily self\u2010replacement ring pessary therapy prevented adverse clinical symptoms. However, abnormal intravaginal microbiota was frequently observed during self\u2010replacement of ring pessary therapy as with continuous usage. Regardless, pelvic examinations should be performed routinely.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14242","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T03:50:12Z","timestamp":1584589812000},"page":"931-938","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Changes of intravaginal microbiota and inflammation after self\u2010replacement ring pessary therapy compared to continuous ring pessary usage for pelvic organ prolapse"],"prefix":"10.1111","volume":"46","author":[{"given":"Kazuaki","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Wakamatsu Hospital of University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuo","family":"Morotomi","sequence":"additional","affiliation":[{"name":"Department of Microbiology University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumasa","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Microbiology University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuhiko","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatsumi","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Microbiology University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2009.08.010"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02380.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2329-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2811-9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.53.4.308"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.29.2.297-301.1991"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.04.018"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043802"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.05213-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1099\/mic.0.26905-0"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-005-0049-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2180-5-61"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.14242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.14242","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T11:51:00Z","timestamp":1694001060000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.14242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,18]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1111\/jog.14242"],"URL":"https:\/\/doi.org\/10.1111\/jog.14242","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,18]]},"assertion":[{"value":"2019-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}