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Pessary-Related Ulcers in Postmenopausal Women Not Associated With Bacterial Vaginosis: Presented at AUGS By Laura Gater CHICAGO -- September 9, 2008 -- Bacterial vaginosis (BV) does not appear to be linked to the development of vaginal discharge or vaginal ulcers in postmenopausal women who use pessaries for treatment of pelvic organ prolapse, according to research presented here at the American Urogynecologic Society 29th Annual Scientific Meeting (AUGS). Women with advanced pelvic organ prolapse who receive a pessary to manage symptoms often develop a vaginal discharge that is clinically similar to BV, said researcher My-Le To, DO, University of Illinois, Chicago, Illinois, in a presentation on September 6. To determine if bacterial vaginosis due to vaginal pessary use predisposes postmenopausal women to the development of vaginal ulcers, Dr. To and colleagues enrolled 115 women. The types of pessary used were ring, donut, gellhorn, gehrung, cube, and incontinence ring. Thirty-five (30.4%) women developed ulcers. Of these, 29% chose to have surgical removal of the ulcers. The remaining women were treated with either a topical oestrogen cream or topical metronidazole vaginal gel (P > .05). No significant difference was noted in time to ulcer resolution between the 2 topical treatments. Mean time to resolution with topical treatment was 2 weeks. Chi-square analysis showed a significant association between the type of pessary used and incidence of ulcers (P = .032). One-way analysis of variance proved an association between the type of pessary worn and ulcer size (P = .031). The highest rates of ulceration occurred with the cube (75%), the gehrung (50%), and the gellhorn (48.6%). The donut (35.7%) and the ring (18.8%) caused the lowest rates of ulceration. None of the bacterial vaginosis tests were positive. Bacterial vaginosis does not appear to be linked to the development of vaginal discharge or ulcer formation in postmenopausal pessary users, Dr. To concluded. She stated that she could not comment on whether or not time alone was just as beneficial as topical treatment. The study's strengths were that it was a systematic follow-up of 115 women with pessary use; it provided a "natural history" of pessaries worn over a 12-month period; and it was a prospective study. Dr. To concluded that further study comparing topical oestrogen versus placebo in attempt to decrease the rate of ulcer formation is indicated. Funding for this study was provided by Novasys Medical. [Presentation title: Are Pessary Related Ulcers in Post Menopausal Women Associated With Bacterial Vaginosis (BV)? Paper 81] E-mail this page to a friend or colleague! To print, use this version