Fistula formation after usage of pessary for pelvic organ prolapse: a case series

Hnin Yee Kyaw; Hannah G. Krause; Judith T. W. Goh

doi:10.1071/CJ24041

RESEARCH ARTICLE (Open Access)

Previous Contents Vol 31(1)

Fistula formation after usage of pessary for pelvic organ prolapse: a case series

Hnin Yee Kyaw ^A ^* , Hannah G. Krause ^A ^B ^C and Judith T. W. Goh ^A ^B ^D

+ Author Affiliations

- Author Affiliations

^A Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld 4215, Australia.

^B Greenslopes Private Hospital, Newdegate Street, Greenslopes, Qld 4120, Australia.

^C The University of Queensland, Brisbane, Qld 4072, Australia.

^D Griffith University, School of Medicine and Dentistry, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia.

^* Correspondence to: hninyk13@gmail.com

Australian and New Zealand Continence Journal 31, CJ24041 https://doi.org/10.1071/CJ24041

Submitted: 24 September 2024 Accepted: 13 December 2024 Published: 3 February 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Continence Foundation of Australia. This is an open access article distributed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC)

Abstract

A case series of five women with genital tract fistula formation as a complication of vaginal pessary use for pelvic organ prolapse is presented, along with treatment provided and patient outcomes. Review on this topic reveals specific pessary types more commonly associated with severe complications. Recommendations to reduce such complications include careful patient selection, regular follow-up with physical examination, vigilance to enable early recognition of such complications and offering alternative treatment options. Surgical repair of genital tract fistula with concurrent prolapse surgery is feasible and effective.

Keywords: fistula surgery, gynaecological surgery, gynaecologic surgical procedures, pelvic organ prolapse, pessaries, rectovaginal fistula, vesicovaginal fistula.

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