Effect Of Pessaries On Vaginal Microenvironment Changes In Postmenopausal Women

Pelvic organ prolapse(POP)is a type of disease in which the pelvic organs of the pelvic floor muscles,fascia,ligaments and their nerves are weakened by the pelvic floor support system and are removed from the normal place.With the increase in human life expectancy,the incidence of the disease is also increasing year by year.Some studies have pointed out that by 2050,the incidence of POP will be close to 50%.As a conservative method for the treatment of severe POP,pessary is widely used in POP patients with severe clinical complications,advanced age,and intolerable surgery.Up to 92% of patients have symptoms relieved by wearing a pessary,and at the same time,they have high safety.No trauma and no pain,it is favored by the majority of patients.There are also many studied about the efficacy and safety of silicone pessary,but there are few studies on vaginal microenvironment.However,the vaginal microenvironment can not be ignored.Once it is disordered,it will lead to various vaginal inflammation and reproductive tract symptoms.At present,80 patients with pessary treatment of POP in the Third Affiliated Hospital of Zhengzhou University conducted a series of studies on the vaginal micro-environment of silicone pessary by collecting vaginal discharge and vaginal lavage before and after uterine care.ObjectiveTo study the changes of vaginal microenvironment in 80 patients before and after 1 month and 6 months after uterine care,and to evaluate the safety of pessary treatment of POP from the perspective of vaginal microenvironment.MethodsEighty patients with severe POP(self-control)were treated with pessary.The vaginal discharges before and after vaginal discharge were routinely examined for vaginal discharge.The inflammatory factors IL-2 and IL-8 in vaginal lavage fluid were detected by enzyme-linked immunosorbent assay.Results1.The concentrations of IL-2 and IL-8 before placement of pessary were 12.12±1.38pg/ml,214.23±50.50pg/ml,and the concentration at 1 month after placement of pessary was 12.74±1.31pg/ml,respectively,264.54 ±65.78pg/ml,compared with before,the concentration of inflammatory factors IL-2 and IL-8 increased after 1 month,the difference was statistically significant;2.IL-2,after half a year the IL-8 concentrations were 12.28±1.27pg/ml and 229.01±51.30pg/ml,respectively,and the inflammatory factors gradually decreased and approached the pre-dose criteria.3.There was no statistical difference in the changes of white blood cells,lactobacilli,vulvovaginal candidiasis and trichomonas vaginitis before and after routine testing of leucorrhea.4.The incidence of bacterial vaginosis increased 1 month after placement.The difference was statistically significant,and there was no significant difference between the six months after placement and before placement.Conclusion1.After placement of the pessary,there is no significant effect on the lactobacilli,white blood cells and pH in the vaginal secretions,which will not lead to an increase in the incidence of TV and VVC.The incidence of BV in the initial stage of placement is slightly increased,and it is not obvious changes after placement for half a year.Long-term placement will not break the balance of the environment inside the vagina.2.After placing the pessary,the concentration of IL-2 and IL-8 in the vaginal lavage fluid will increase slightly in the initial stage,but with the adjustment and adaptation of the group itself,it can gradually decrease and close to the normal level after half a year.