{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:28:57Z","timestamp":1766518137310,"version":"3.48.0"},"reference-count":27,"publisher":"Informa UK Limited","issue":"4","license":[{"start":{"date-parts":[[2015,11,3]],"date-time":"2015-11-03T00:00:00Z","timestamp":1446508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Post Reprod Health"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pelvic organ prolapse is often co-existant with atrophy of the genital tract in older women who tend to prefer vaginal pessaries for prolapse. Vaginal estrogen therapy is used by some along with a support pessary for prolapse with no robust evidence to back this practice. We aimed to evaluate differences in complications of support pessaries for vaginal prolapse in postmenopausal women, with and without vaginal estrogen use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>We prospectively assessed postmenopausal women attending the urogynaecology clinic for a pessary change. We asked them about the level of discomfort during pessary change (visual analogue scale for pain), discharge, bleeding and infection. Ethics approval was not required as this was a service evaluation project. Statistical analysis for relative risk was performed, including sub-group analysis for \u2018ring pessary\u2019 and \u2018non-ring group\u2019 (Shelf, Gellhorn, Shaatz).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between July 2013 and December 2014, we assessed 120 postmenopausal women using support pessaries for prolapse. The mean age was 70 years; 45% of the patients used vaginal estrogen. There were no statistically significant differences in complications with or without vaginal estrogen use, although the trend was higher amongst non-users. The \u2018non-ring\u2019 sub-group not using vaginal estrogen had a higher risk of vaginal ulceration, bleeding and discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Postmenopausal women may have lesser complications when using vaginal estrogen with a support pessary for prolapse, particularly with pessaries other than the ring. An adequately powered randomised controlled trial is needed to assess conclusively whether vaginal estrogen enhances comfort and reduces complications of support pessaries for prolapse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2053369115614704","type":"journal-article","created":{"date-parts":[[2015,11,4]],"date-time":"2015-11-04T20:18:37Z","timestamp":1446668317000},"page":"141-145","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Does vaginal estrogen treatment with support pessaries in vaginal prolapse reduce complications?"],"prefix":"10.1080","volume":"21","author":[{"given":"Supriya","family":"Bulchandani","sequence":"first","affiliation":[{"name":"Birmingham Women\u2019s NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Toozs-Hobson","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Verghese","sequence":"additional","affiliation":[{"name":"School of Clinical and Experimental Medicine, University of Birmingham, Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pallavi","family":"Latthe","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s NHS Foundation Trust, Birmingham, UK"},{"name":"School of Clinical and Experimental Medicine, University of Birmingham, Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"301","published-online":{"date-parts":[[2015,11,3]]},"reference":[{"key":"bibr1-2053369115614704","doi-asserted-by":"crossref","unstructured":"Hagen S, Stark D, Maher C, et\u00a0al. Conservative management of pelvic organ prolapse in women.\n                      Cochrane Database Syst Rev\n                      2006: CD003882.","DOI":"10.1002\/14651858.CD003882.pub3"},{"key":"bibr2-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.10.602"},{"key":"bibr3-2053369115614704","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s00192-010-1340-9","volume":"22","author":"Shah SM","year":"2011","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"bibr4-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1340-9"},{"key":"bibr5-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.08.013"},{"key":"bibr6-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.10.711"},{"key":"bibr7-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.02.006"},{"key":"bibr8-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30888-4"},{"key":"bibr9-2053369115614704","doi-asserted-by":"publisher","DOI":"10.3109\/00016348409155509"},{"key":"bibr10-2053369115614704","first-page":"3090","volume":"61","author":"Bachmann GA","year":"2000","journal-title":"Am Fam Physician"},{"key":"bibr11-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2554-z"},{"key":"bibr12-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/0378-5122(94)00863-3"},{"key":"bibr13-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818aa7c3"},{"key":"bibr14-2053369115614704","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2010.481058"},{"key":"bibr15-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1080\/13697130701361657"},{"key":"bibr16-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e31817b076a"},{"key":"bibr17-2053369115614704","first-page":"CD007063","volume":"9","author":"Ismail SI1","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr18-2053369115614704","first-page":"1","volume":"13","author":"Deger RB","year":"1993","journal-title":"Postgrad Obstet Gynecol"},{"key":"bibr19-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000222903.38684.cc"},{"key":"bibr20-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2005.09.003"},{"key":"bibr21-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-005-1362-x"},{"key":"bibr22-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-010-1675-y"},{"key":"bibr23-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.02.018"},{"key":"bibr24-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-004-1226-9"},{"key":"bibr25-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.07.024"},{"key":"bibr26-2053369115614704","unstructured":"Armstrong K, Dessie S, Modest A, et\u00a0al. The Effect Of Vaginal Estrogen On Pessary Usage. Unpublished poster presentation at ICS in Rio de Janeiro. www.ics.org\/Abstracts\/Publish\/218\/000704.pdf (2014, accessed 31 August 2015)."},{"key":"bibr27-2053369115614704","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2013.09.019"}],"container-title":["Post Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2053369115614704","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2053369115614704","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2053369115614704","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:25:06Z","timestamp":1766517906000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2053369115614704"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,3]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1177\/2053369115614704"],"URL":"https:\/\/doi.org\/10.1177\/2053369115614704","relation":{},"ISSN":["2053-3691","2053-3705"],"issn-type":[{"type":"print","value":"2053-3691"},{"type":"electronic","value":"2053-3705"}],"subject":[],"published":{"date-parts":[[2015,11,3]]}}}