Effects of the incontinence dish pessary on urethral support and urodynamic parameters

• Published in: American journal of obstetrics and gynecology 2008-05, Vol.198 (5), p.592.e1-592.e5
• Main Authors: Noblett, Karen L., MD, McKinney, Amanda, MD, Lane, Felicia L., MD
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Equipment Design; Female; Gynecology. Andrology. Obstetrics; Humans; incontinence; Logistic Models; Medical sciences; Nephrology. Urinary tract diseases; Obstetrics and Gynecology; Odds Ratio; Pessaries; pessary; Prospective Studies; Q-tip test; Urethra - physiopathology; Urinary Incontinence - therapy; Urinary Incontinence, Stress - therapy; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urodynamics; Uterine Prolapse - therapy
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.02.004

Objective To evaluate the effects of the incontinence dish pessary (IDP) on urethral mobility and urodynamics. Study Design Prospective study of women with symptoms of stress incontinence. Q-tip test was performed recording the resting and straining angles with and without an IDP. Changes in resting and straining angles were calculated. Those with evidence of urodynamic stress incontinence had urodynamics with the IDP. Paired t-test was used to compare the difference in Q-tip angles with and without the pessary. Results Mean Q-tip straining angle without and with the pessary, respectively, was 57.8 (+19.5) and 34.4 (+29.7). Mean change was 23.5 (+18.5) P < .00001. Maximum urethral closure pressure (MUCP) was significantly increased by 19.7 cm H2 0 P < .001. Overall, 60% of the subjects did not leak with the IDP. Conclusion The IDP eliminates >60% of USI. The mechanism of action may be a combination of improved UVJ support and increased MUCP.