Avaliação da utilização do pessário vaginal na qualidade de vida de mulheres com prolapso de órgãos pélvicos atendidas em um ambulatório especializado

Abstract

Pelvic organ prolapse is a highly prevalent gynecological condition that promotes impact not only in clinical aspects but also affects the social and psychological sphere, influencing the quality of life of women who have this condition. The use of pessary as a conservative treatment is an alternative that has been widely used, since it has a positive impact, considerably improving the quality of life, restoring self-image and confidence, allowing women to resume their normal activities and thus increasing their overall satisfaction With the life. This study aims to evaluate the quality of life of women with pelvic organ prolapse treated at a specialized outpatient clinic of a tertiary hospital before and after the use of the pessary. This is a longitudinal and prospective observational study, developed with an initial sample of 139 women who presented symptomatic prolapse in an outpatient clinic in Urogynecology, from November 2013 to April 2019, through the application of two questionnaires: Medical Outcomes Study 36 - Item Short-Form Health Survey and Prolapse Quality-of-Life Questionnaire at the first consultation for vaginal pessary use and four months after continuous use of the device. The data were compiled and analyzed using the statistical program Statistical Package for Social Science 23.0 version for Windows. Results: In the present study the sociodemographic profile obtained was of women with a mean age of 66.7 years, an average of 5.1 years of studies, 24.5% of them illiterate. Most were from the capital of Fortaleza and had an average income of 1,395.85 reais. More than half were retired and had no partners. There was a predominance of nonsmokers who had an inadequate body mass index. The most frequent clinical and gynecological-obstetric history were hypertension, presence of previous pelvic surgery, with hysterectomy, mean of 6.2 pregnancies, 5.1 deliveries and 0.9 abortions. The main vaginal delivery route and the mean infant birth weight were 3,963.27 grams. Most of the women were in stages III and IV of the prolapse, referring to sensation of ball in the vagina, looseness, urinary and menopausal complaints. Regarding the general quality of life questionnaire, a significant increase was found in all domains evaluated by the instrument, except for the domain "Limitation of social aspects". On the specific questionnaire, a significant reduction of all the domains of the instrument was identified. These data represent a significant improvement in the quality of life of women with symptomatic prolapse in the use of vaginal pessaries as a conservative treatment.