Host Response to Pessaries in Microbial Communities of the Postmenopausal Vagina

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