Patient-Specific Pessaries After Suboptimal Outcomes With Standard Pessary Use.

Abstract

To evaluate fitting success, continuation of use, and adoption patterns of patient-specific pessaries among individuals with prior unsuccessful or suboptimal outcomes with standard pessaries. We conducted a retrospective case series of patients who underwent fitting of a patient-specific pessary between February 2024 and September 2025 across 18 clinical sites in Canada. All fittings, design selections, and outcomes were recorded in a centralized cloud-based platform. Eligibility included symptomatic pelvic organ prolapse with current or prior pessary use or previous unsuccessful fittings. Clinicians could design up to two pessaries per round with iterative refinement. The primary outcome was successful use , defined as the patient's decision to retain and continue using the pessary after up to two fitting rounds and a 4-week home trial. A total of 113 patients underwent fitting of a patient-specific pessary. Initial fitting success was achieved in 87 patients (77.0%, 95% CI, 68.5-83.7%). Of these, 69 (79.3%, 95% CI, 69.7-86.5%) elected to continue using the device after the home trial. Twenty-six patients (23.0%) were not successfully fitted in the first round, of whom seven pursued a second round; four were successfully fitted, and three continued use after the home trial. Overall, 72 of 113 patients (63.7%, 95% CI, 54.5-72.1%) retained and continued using their patient-specific pessary at the final follow-up. Patient-specific pessaries achieved high fitting success and continuation rates among individuals who previously had unsuccessful or suboptimal outcomes with standard pessaries. These findings support the clinical utility of individualized devices as a nonsurgical treatment option for pelvic organ prolapse.