The Success Rate of Hong Kong Chinese Women with Pelvic Organ Prolapse in Pessary Self-Management: a Multi-Centered Prospective Study

The objective was to determine the success rate of pessary self-management (PSM) and identify influencing factors among the Hong Kong Chinese population with pelvic organ prolapse (POP). A prospective study was conducted from November 2023 to April 2024 across three local tertiary hospitals. A total of 165 Chinese women with POP using a ring pessary were enrolled. Exclusion criteria included dependency, limited dexterity, and cognitive impairment. Participants received a standardized one-to-one PSM teaching session. Success was defined as continuing PSM at the 1-year follow-up. Statistical analysis identified factors associated with success. The PSM success rate was 86.7% (143 out of 165). The successful group was significantly younger (mean 68.7 vs 73.9 years, p = 0.011), had higher education levels (p = 0.023), with lower parity (median 2 vs 3, p = 0.048), and less advanced stages of POP (88% stages 1–2 vs 54.5%, p < 0.001). Contrary to initial hypotheses, successful PSM was associated with the use of a larger pessary (69.8 mm vs 66.6 mm, p = 0.047). PSM is a highly viable and successful strategy for Chinese women, with a success rate comparable with Western populations. Key factors for success include younger age, higher education, milder prolapse, and the use of a larger pessary. These findings support the early introduction of PSM to suitable patients to enhance patient empowerment and optimize conservative POP management.