Pessaries customized via ultrasound, 3D printing beneficial for pelvic organ prolapse

Key takeaways:

• Pessaries customized with ultrasound and 3D technology resulted in significant improvements for women with pelvic organ prolapse.
• None of the participants reported any adverse events during the study period.

Pessaries customized through transvaginal ultrasound and 3D printing technology may perform better if commercial pessaries fail for women with pelvic organ prolapse, according to results of a pilot study published in Menopause.

“Each woman presents with unique anatomy, and thus, the effectiveness of commercially available pessaries may be limited by lack of customization,” Yi-Hao Lin, MD, from the division of urogynecology in the department of obstetrics and gynecology at the Chang Gung Memorial Hospital School of Medicine in Taoyuan, Taiwan, and colleagues wrote. “Recently, as a novel technology, 3D printing has been widely adopted in various fields of medicine. However, the technology has only just begun to branch into the field of gynecology and obstetrics.”

From January to June 2021, Lin and colleagues conducted a pilot study at a tertiary urogynecology unit in Taiwan with six women (mean age, 68 years) who opted for self-management of symptomatic pelvic organ prolapse using Gellhorn pessaries. The pessary was placed in the vagina to restore the prolapsed tissues, and transvaginal ultrasound evaluated the gap. Following this, researchers used an impression silicone to mold the appropriate shape for the pessary to complete a participant-specific template. After collecting the template, researchers applied 3D printing to customize the silicone vaginal pessary to each individual participant.

All participants completed multiple validated quality of life questionnaires at baseline and 3 and 6 months.

Researchers observed improvements for all participants for the Urogenital Distress Inventory 6 questionnaire (P = .032), Incontinence Impact Questionnaire 7 (P = .006) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (P < .001).

No participants reported adverse events, including discomfort, expulsion of the pessary, urinary incontinence, difficulty urinating or producing bowel movements or vaginal bleeding.

According to the researchers, they plan to continue to make improvements in this field of customizable pessary with 3D printing technology to make customizable treatment for pelvic organ prolapse achievable anywhere in the world.

“We have come up with a creative approach by using ultrasound with 3D processing to meet the needs of these women,” the researchers wrote. “Hopefully, our ideas will inspire more obstetricians and gynecologists to make this goal a reality by providing better care, thereby improving the quality of life for women with pelvic organ prolapse.”