The effect of Pessaries on Vaginal Micro environment

Background: Pessary is a medical device inserted into the vagina, either to provide structural support or as a method of delivering medication. For the treatment of urinary incontinence, pelvic organ prolapse, pessaries have been utilized. Aim: The aim of the study was to evaluate the differences in vaginal discharge between postmenopausal women who wear pessaries and those who do not to explain pessary related, bacterial vaginosis vaginal discharge by microscopy, gram staining. Materials and Methods: 150 women were selected for the study and the study was conducted at Government hospital Nizamabad and CKM hospital, Warangal. 75 Women were post-menopausal who had worn Pessaries for at least 4months and were in group A. 75 Women didn't wear Pessaries and were presenting for pessary fitting. Women who were postmenopausal, women who had worn pessaries for atleast 4 months or had never worn pessary and were presenting for pessary fitting were included. Results: Group A was older and had been for a longer time menopausal when compared to Group B. Years since menopause was higher in group A when compared to group B. Women in group A were more bothered by discharge when compared to group B. Women in group A were more likely to meet amsel's and nugent's criteria for bacterial vaginosis. In group A, the WBC's were greater than 10 per hpf when compared to group B by microscopy. Clue cells were higher in group A when compared to group B. pH also was higher in group A when compared to group B. Conclusion: Bothersome vaginal discharge may be due to vaginal inflammatory process and it develops early and is pessary related.