Management of stress urinary incontinence using vaginal incontinence pessaries in rural Kilimanjaro, Tanzania

Benjamin C. ShayoEmail authorDiva J. MwakanyamaleGileard G. MasengaVibeke Rasch
Publication year: 

Introduction and hypothesis

The effect of incontinence pessaries for urine incontinence (UI) has previously been described in studies from high-income countries, where they have been documented to reduce urinary leakage significantly. However, there is a profound literature gap in these data in low- and middle-income countries. This study, therefore, aims to describe the acceptance, impact and complications of pessary treatment among Tanzanian women diagnosed with stress UI.


Women who reported stress UI underwent a stress test, and if positive they were offered an incontinence pessary. Swahili versions of the Urinary Distress Inventory-6 (UDI-6) and the Urinary Impact Questionnaire (UIQ) were administered at 3- and 12–18-month follow-ups in addition to questions regarding pessary acceptance and pelvic examination for complications.


A total of 48 women were fitted with an incontinence pessary. The frequency and amount of leakage were reduced significantly at 3- and 12–18-month follow-up. Additionally, a significant reduction in the overall UDI-6 score from 29.2 to 25.0 and overall UIQ score from 52.1 to 25.0 was observed from baseline to 3-month follow-up. Thirty-seven per cent of the women reported vaginal discharge at 12–18 months while signs of infection were found in 11.5%. In all, 32/48 (67%) wanted to continue the pessary treatment at 12–18-month follow-up.


In the setting studied, pessaries for stress UI can be successfully fitted in most women with considerable acceptance and satisfaction rates and minimal complications.