The objective of the study was to compare pelvic floor symptom changes in patients who continue vs discontinue pessary use, and determine whether changes predict pessary continuation.

Women fitted with pessaries completed the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary use. Scores were compared in women who continued vs discontinued pessaries. Analysis of covariance adjusted for baseline differences in scores. Logistic regression and receiver operating characteristic curves were used to find a score predicting pessary continuation.

Sixty-four women had complete follow up data; at 6-12 months, 36 of 64 (56%) continued pessary use, and 28 of 64 (44%) discontinued use. The continuation group’s final PFDI-20 total, bladder, and prolapse scale scores were better than the discontinuation group’s. A 2-month prolapse score that fell to 50% of baseline best predicted pessary continuation.

PFDI-20 scores improved most in women continuing pessary use. Pessaries effectively treated urinary symptoms, and most effectively treated prolapse symptoms. Prolapse score improvement best predicted continued pessary use.