International Urogynecology Journal

, Volume 11, Issue 4, pp 219–223 | Cite as

Bacterial Vaginosis Increases in Pessary Users

  • B. Alnaif
  • H. P. Drutz
Original Article


The purpose of this study was to examine the association between pessary use, smoking and changes in the vaginal flora. Patients using pessaries were age matched with non-pessary using controls. All candidates examined were women attending the Mount Sinai Hospital, Toronto, for genitourinary problems. Vaginal cultures were routinely performed on all women attending the unit, irrespective of symptoms. Forty-four pessary users were age matched with 176 controls (4 controls per case). The mean age was 60.1 ± 12.6 years, and 15% of these were premenopausal. The duration of pessary use ranged from 0.5 to 8 years (mean 3.3 ± 1.7). Weight, parity, smoking status, diabetes mellitus, thyroid disease, UTI and postvoid residual urine volume were not significantly different between pessary users and controls. Bacterial vaginosis (BV) was noted in 32% of pessary users, versus 10% of controls. The relative risk of developing BV in pessary users was 3.3 (OR, 4.37; 95% CI, 2.15–9.32), P= 0.0002. Smoking independently affected the vaginal flora, increasing the relative risk of developing BV to 2.9 (OR, 3.78; 95% CI, 2.05–8.25), P = 0.0013. It was concluded that pessary use is a very effective and conservative method for the treatment of genital prolapse. However, we found that the presence of a foreign body was associated with changes in the vaginal flora, thereby increasing the odds of developing bacterial vaginosis to 4.37; this was further compounded by smoking.

Key words:Bacterial vaginosis – Historical cohort study – Pessary – Smoking 


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Copyright information

© Springer-Verlag London Limited 2000

Authors and Affiliations

  • B. Alnaif
    • 1
  • H. P. Drutz
    • 2
  1. 1.Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USAUS
  2. 2.University of Toronto, Mount Sinai Hospital, Toronto, Ontario, CanadaCA

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