Host Response to Pessaries in Microbial Communities of the Postmenopausal Vagina

Host Response to Pessaries in Microbial Communities of the Postmenopausal

The ability to determine the postmenopausal vaginal environment and the impact of pessary use could help to maximize pessary therapy and non-surgical treatment for such a prevalent problem.

The study will advance the care of elderly patients through providing data to maximize non-surgical options to those at high risk for having surgery and its attending morbidity. In characterizing substantive differences in the vaginal environment of successful and unsuccessful pessary users, the investigators can identify elderly patients at higher risk of adverse events with pessary use as well as novel targets for the pharmacologic treatment of the altered vaginal microbiota and endogenous AMP levels, potentially allowing patients to continue with non-surgical therapies rather than pursuing surgical intervention.

Inclusion Criteria:

• must be English speaking
• appropriate for pessary treatment
• pelvic floor conditions such as POP (with or without the presence of a uterus), stress urinary incontinence, urge urinary incontinence, or any combination of the above.

Exclusion Criteria:

• a history of current, symptomatic vaginal stricture
• a history of current, radiation therapy,
• or current treatment with auto-immune suppression agents.
• if they have eroded mesh in the vagina from prior pelvic floor surgery