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PubMedDate not supplied

Cytologic changes associated with vaginal pessary use. With special reference to the presence of Actinomyces.

The cytopathology of Papanicolaou smears from 23 postmenopausal women with vaginal pessaries is described. The following alterations, when seen in the smear of an elderly postmenopausal woman, were found to be strongly suggestive of pessary use: cytologic atypia in the form of severe inflammatory changes in squamous cells, atypical metaplasia, and reparative changes with a background pattern of acute inflammation and prominent superficial maturation of the squamous cells. A notable additional finding in 13 of the 23 patients was the presence of filamentous organisms resembling Actinomyces and morphologically similar to organisms recently described and specifically identified as Actinomyces in patients with intrauterine devices.

Actinomyces↗
PubMed1978

[Non-invasive cerclage using supportive pessaries for prevention and therapy of premature birth].

It was told about a pessary, with the help of which could be done an excellent therapy and prophylaxis of the threatening of a partus prämaturus imminens in cervixinsufficiency. To make use of it is very simple. With the help of this method one could lower the rate of miscarriages to 3,6% in comparison to a period without cerclage or pessary, when the rate of premature children was 6,6%.

Adult↗
PubMed1984

Induction of labor using high-dose or low-dose prostaglandin vaginal pessaries.

Two hundred women were studied in a randomized controlled trial of induction of labor using high-dose (3 mg) or low-dose (0.5 mg) prostaglandin E2 vaginal pessaries. Induction using 3-mg pessaries was more successful, with a shorter overall induction-delivery interval and less requirement for analgesia, although uterine hyperstimulation occurred in two patients. In contrast, the low-dose regimen did not cause hypertonus and, though less successful in inducing labor, the total dose of prostaglandin E2 used was considerably less than in the 3-mg group. The cesarean section rate when the cervix was initially unfavorable was high in both groups (high dose 18.2%, low dose 16.7%). The response to prostaglandin E2 did not relate closely to the initial cervical state.

Cesarean Section↗
PubMed1984

A double blind controlled trial to study the effects of vaginal prostaglandin pessaries on induction of labour and improvement in the favourability of the cervix.

In a double blind trial of prostaglandin pessaries to induce labour, prostaglandins were successful in 47.5% of primiparous and 70.6% of multiparous patients. Of the 66% who did not go into labour this was successfully induced by artificial rupture of the membranes and oxytocin infusion in all but two cases irrespective of whether or not they received the active compound. This trial suggests that prostaglandin pessaries are a useful and very acceptable way of inducing labour and that although they make the cervix more "favourable" they do not significantly alter the outcome of labour. In the light of their high cost it is time that this method of induction and its timing was re-evaluated.

Cervix Uteri↗
PubMed1978

[A cubical support pessary within the scope of complex therapy of threatening prematurity].

Report about experience with a cubic supperting pessary for the prophylaxis and therapy in cervixinsufficiency or inpending premature delivery. The indication, selection, evaluation of riscfactors and the application of a complex therapy are discussed.--Information on therapeutic results and a first conclusion concerning the longtime incorporation of pessaries during pregnancy and the questions related to this. For the period under review, in which intensive prophylactic measures were carried out, a considerable decrease in premature deliveries could be achieved in the territory of pregnancy care center attached to our hospital.

Abortion, Threatened↗
PubMed1983

[Changes in the vaginal flora caused by supporting pessary treatment in pregnancy].

200 pregnant women with supporting pessary treatment because of cervical insufficiency were compared with one of normal pregnancies concerning microbiological findings and puerperal morbidity. -- 5,5% of the women in the supporting pessary group had pathogenic organisms in their cervix before first amnioscopy, compared to 2% in the control group. The different results of cultural microbiologic examinations in both groups depend on type and duration of birth as well as time of amnion rupture. Women with premature rupture of the membranes (31,0%) had more pathogenic organisms than women with rupture (2,5%) in time. There was no higher infection morbidity compared to the control group.

Female↗
PubMed1994

[Beeswax pessary in conservative treatment of uterine prolapse].

The own method of uterine prolapse treatment with the use of beeswax pessary is presented. The described method is applied in cases where general health conditions do not allow to perform the surgery. The study revealed that the beeswax is a good material to make a vaginal pessary. It's great plasticity allows individual modelling in compliance with anatomical conditions of treated patient. That provides the proper stability of uterine position. The risk of possible urinary stress incontinence due to uterine reposition is also diminished.

Animals↗
PubMed1993

Effect of treatment with povidone-iodine vaginal pessaries on thyroid function.

Twenty women suffering from candidal, trichomonal and non-specific vaginitis were treated by povidone-iodine vaginal pessaries twice daily for 14 days. Blood samples were obtained from patients before and 7 and 14 days after treatment for the determination of serum thyroid stimulating hormone, total thyroxine, free thyroxine, total triiodothyronine, free triiodothyronine, reverse triiodothyronine, thyroxine binding globulin and thyroglobulin by the corresponding specific 125I radioimmunoassay. In addition serum protein bound iodine was determined by a spectrophotometric method. Post-treatment values of these parameters after 7 and 14 days were not significantly different from the corresponding pretreatment values. Vaginal discharge disappeared in 82% of patients; with partial improvement in the remaining 18%. No clinical side effects and no clinical evidence of thyroid disorder were found in any of the women. These results indicate that treatment with povidone-iodine vaginal pessaries is effective in the treatment of different forms of vaginitis and their daily use in euthyroid, non-pregnant women is safe and has no effect on thyroid function.

Adolescent↗
PubMedDate not supplied

Use of a pessary for the management of pelvic organ prolapse.

Pessaries provide nonsurgical management of pelvic organ prolapse in women who are not viable candidates for or who do not choose to undergo surgical intervention. It is necessary to take into consideration that when pessary use is indicated, it is crucial that the clinician assess the physical and mental capabilities of the individual. A client with compromised eyesight or motor abilities may not be able to manage the insertion and subsequent care of the device.

Adult↗
PubMed1978

Preoperative cervical dilatation with 15(S)15-methyl PGF2alpha methyl ester pessaries.

A clinical trial comparing two vaginal dose schedules of 15(S)15-methyl prostaglandin F2alpha (PGF2alpha) methyl ester (4 or 6 mg) for preoperative dilatation of the cervix is described. The trial included 28 patients at 8-12 weeks' gestation. Vaginal pessaries containing either 1.0 mg (15 patients) or 1.5 mg (13 patients) of the prostaglandin analogue were administered every 3 hours (maximum, 4 doses). The success rates for the two groups were 93% and 100%, respectively. Sixty percent of the patients aborted before the planned vacuum aspiration. Minor side effects, primarily vomiting and diarrhea, occurred in approximately 80% of the cases and were more prominent with the higher dose pessary. It is concluded that the vaginal administration of 15(S)15-methyl PGF2alpha methyl ester is highly effective for preoperative dilatation of the cervix before suction curettage abortion.

Abortion, Therapeutic↗
PubMed1994

Induction of labour by balloon catheter with extra-amniotic saline infusion (BCEAS): a randomised comparison with PGE2 vaginal pessaries.

OBJECTIVE: A new method for induction of labour--balloon catheter with extra-amniotic saline infusion (BCEAS)--is evaluated in randomised comparison with prostaglandin E2 (PGE2) in vaginal pessaries. STUDY GROUP: One-hundred and nine pregnant women with unfavourable cervices. MAJOR OUTCOME MEASURES: The efficiency of inducing vaginal delivery and the level of 'disadvantages following induction of labour' (DisFIL scorings). RESULTS: Overall, BCEAS was less efficient inducing vaginal delivery than vaginal PGE2 (P < 0.01) because of a significant difference among parous women (P < 0.01). In the (larger) primiparous women group, and particularly in the subgroup of these having very low pelvic scores (Lange score, < or = 3), the efficiencies of the two methods were equal (P = 0.06) and P = 0.55, respectively). The levels of DisFIL scorings were not significantly different. However, higher rates of caesarean section followed BCEAS than PGE2 (29% and 10%, respectively; P < 0.05). Serious infectious complications were not recorded following BCEAS. No difference was apparent in the status of the neonates (judging from Apgar scores and umbilical artery pH and SBE). The women, delivering vaginally, commented the two methods equally favourably. CONCLUSION: BCEAS was less efficacious than vaginal PGE2 pessaries, though among primiparous women, especially those with very unfavourable cervices, the difference was not significant. Further refinements of the method are suggested.

Administration, Intravaginal↗
PubMed1991

Effect of rumen degradable bolus containing melatonin or progestagen pessary plus pregnant mare serum gonadotropin on estrus response and lambing rate in ewes.

Two practical regimens designed to induce estrus and ovulation in ewes in late anestrus were compared. Forty ewes were given a soluble glass rumen bolus containing 150 mg melatonin on July 9 and were joined with two vasectomized rams on July 23 and with three fertile rams on August 6. A second group of 40 ewes was treated with an intravaginal progestagen pessary (60mg medroxy-progesterone acetate) on July 23. Following pessary removal after 12 d, ewes were given 750 IU of pregnant mare serum gonadotropin (PMSG). Five fertile rams were joined with these ewes 48 h after progestagen removal. Melatonin concentrations were determined in single blood samples collected in early afternoon of July 21. Mating dates, lambing dates and litter sizes were recorded. Date of mating was significantly later in ewes treated with melatonin compared with those treated with progestagen plus PMSG (P<0.0001). All ewes given melatonin were mated within 4 wk, and those on progestagen plus PMSG treatment within one day of fertile ram introduction. Thirty-four ewes (85%) allocated to melatonin treatment and 36 (90%) allocated to progestagen plus PMSG treatment lambed (P>0.05). Mean (+/-SEM) lambing date was later in melatonin-treated ewes (January 17+/-1.2 d) compared to those given progestagen plus PMSG (December 30+/-0.6 d; P<0.0001). Mean litter size was lower in melatonin-treated ewes (1.5+/-0.1) compared with those given progestagen plus PMSG (2.0+/-0.1; P<0.001). Plasma melatonin concentrations indicated that 9 of 40 ewes treated with melatonin had circulating melatonin concentrations of less than 16 pg/ml. It is concluded that under conditions that existed in this experiment, treatment with progestagen plus PMSG in late anestrus resulted in more synchronous mating and lambing and a higher litter size than that following administration of a soluble glass rumen-degradable bolus containing melatonin.

Journal Article↗
PubMed2001

Efficacy of 7-day treatment with metronidazole+miconazole (Neo-Penotran) - a triple-active pessary for the treatment of single and mixed vaginal infections.

OBJECTIVE: To evaluate the efficacy of Neo-Penotran pessaries (metronidazole 500 mg + miconazole nitrate 100 mg) in candidal, bacterial and trichomonal vaginitis and in mixed vaginal infections. METHOD: Ninety-seven patients with clinical diagnosis of vaginitis entered this open, non-comparative study. Each patient inserted one pessary twice daily for 7 days. Gynecological and microbiological assessments were carried out before, and 8-10/21-23 days after the start of treatment. RESULTS: Vaginitis symptoms were resolved in 91% of the 74 patients evaluated, and improved in a further 7%. Microbiological cure rates were 97.3% for trichomonal, 86.6% for bacterial and 81% for candidal vaginitis. Recurrence rates were 2.7, 3.8 and 16.1%, respectively. Overall microbiological cure rate for mixed infections was 86%, with 93% for trichomonal+bacterial, and 73% for bacterial+candidal vaginitis. In two out of three cases with trichomonal+bacterial+candidal infection, the microorganisms were eradicated completely. CONCLUSION: Neo-Penotran provides immediate and effective treatment for vaginitis, irrespective of single or multiple infection, even when the diagnosis may be uncertain.

Administration, Intravaginal↗
PubMed2001

Vaginal pessary-induced mechanical bowel obstruction.

We present a case of a mechanical bowel obstruction secondary to an impacted vaginal pessary. As the elderly segment of the population continues to grow, pessary use is increasing in absolute numbers, and clinicians must consider these medical devices when evaluating abdominal, gynecological, and urological complaints in elderly women.

Aged↗
PubMed1991

A comparison of Lamicel tents and gemeprost (Cervagem) pessaries prior to first trimester abortion.

In an open, randomized study 108 women were treated with either a Lamicel tent or a 1 mg gemeprost pessary (Cervagem) 4 h before first trimester abortion. Both treatments were effective in producing cervical dilatation, however further dilatation was significantly easier after Cervagem. Preoperative abdominal pain and gastrointestinal side-effects were significantly more frequent in the Cervagem group. The incidence of postoperative pain and blood loss were similar in the two groups. Advantages and disadvantages of the two treatments are mentioned.

Abortifacient Agents, Nonsteroidal↗
PubMed1989

Transfer of prostaglandins to the fetus after prostaglandin E2 vaginal pessary administration.

The kinetics of prostaglandins instilled vaginally has been studied in the maternal and fetal circulations, with observation of changes in the stable prostaglandin E2 metabolite 11-deoxy-13,14-dihydro-15-keto-11 beta,16-cyclo-prostaglandin E2. After the administration of prostaglandin E2, 10 mg in a wax-based pessary, concentrations of prostaglandin E2 metabolite in the maternal circulation increased; concentrations in the fetal circulation were higher than those in control subjects. There was a positive correlation between levels found in the fetal and maternal circulations. The implications of these preliminary findings are discussed in relation to the consequences of the use of vaginally administered prostaglandin E2 for cervical ripening and labor induction.

Abortion, Induced↗
PubMed1989

Induction of early abortion with mifepristone (RU486) and two different doses of prostaglandin pessary (gemeprost).

One-hundred-and-twenty women of less than 56 days amenorrhoea were treated with a single dose of 600 mg of mifepristone in combination with half or a whole 1 mg gemeprost vaginal pessary. Complete abortion was induced in 119 (99%) women and there were no continuing pregnancies. There were few gastro-intestinal side effects following prostaglandin. The smaller dose of prostaglandin caused significantly less severe pain. This study confirmed the effectiveness of mifepristone and prostaglandin for the induction of early abortion but suggests that more research should be carried out to determine the lowest effective doses of both drugs.

Abortifacient Agents↗
PubMed1989

Termination of second trimester pregnancy with gemeprost vaginal pessaries and intra-amniotic PGF2 alpha. A comparative study.

152 women admitted for legal abortion in the second trimester of pregnancy were included in an open, randomized, controlled six-centre study. 75 patients received gemeprost 1 mg vaginal pessaries at 3 hours intervals up to a maximum of 5 mg and 66 patients were treated with a single 40 mg intra-amniotic dose of PGF2 alpha. The 24-hour success rate was 81% (n = 61/75) in the gemeprost and 64% (n = 42/66) in the PGF2 alpha group (p less than 0.02). The mean abortion times were 14.3 and 14.8 hours in the gemeprost and the PGF2 alpha groups, respectively. The mean time to onset of pain was shorter and more patients experienced blood loss over 100 ml during the induction in the PGF2 alpha group than in the gemeprost group (p less than 0.02). Apart from that, the nature and severity of side effects were comparable between the two groups. Besides significantly better efficacy, the non-invasive gemeprost treatment was found to be easier and safer as compared to the PGF2 alpha treatment.

Abortifacient Agents↗