Does a ring pessary in situ influence the pelvic floor muscle function of women with pelvic organ prolapse when tested in supine?

Objective: It has been suggested that repositioning pelvic organ prolapse (POP) by pessary support may improve pelvic floor muscle (PFM) function. The aim of the present study was to compare vaginal resting pressure and maximal voluntary contraction (MVC) of the PFM measured with and without a ring pessary in situ.

Methods: This was a short-term experimental study with women acting as their own controls. Twenty-two women with POP quantified II-IV were included. Vaginal resting pressure and MVC was measured with a manometer (Camtech AS) in supine position. Difference between measurements with and without the ring pessary was analyzed by paired sample t test and Wilcoxon signed rank test. Significance level was <0.05.

Results: There was a statistically significant difference in measurement of vaginal resting pressure (p <0.01) but not of MVC (p= <0.68) with the ring pessary in situ.

Conclusions: Measurement of PFM strength can be done without repositioning the prolapse.