A Problematic Peril of Pessaries: The Rare Case of Rectovaginal Fistulas Resulting From Pessary Use

Abstract

Pelvic organ prolapse (POP) is a condition of herniation of the pelvic organs into the vagina or past the introitus. Management options include pessary use. A very rare complication of pessary usage is erosion resulting in a vesicovaginal or rectovaginal fistula. We present two cases of patients who were found to have rectovaginal fistulas from Gellhorn pessary usage. Both patients were surgically treated with colostomies. Pessary management of POP is very common and accepted form of treatment. For optimal outcomes with pessary use, we recommend that patients be actively managed with individualized periodic evaluations. Estrogen cream may be considered for prevention and treatment of eroded vaginal epithelium.




J Clin Gynecol Obstet. 2015;4(1):193-196
doi: http://dx.doi.org/10.14740/jcgo308w