Patient Perceptions of Pessaries

Objectives: A vaginal pessary is a highly effective, conservative treatment for patients with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Although most patients achieve a successful pessary fitting, only 42-63% of patients counseled on a pessary will choose this modality. Deciding on pessary treatment may be influenced by age, comorbidities, severity of prolapse, and prolapse surgery history. Patient views of pessaries and how their beliefs about pessaries impact their choice of POP/SUI treatment is unknown. Our objective is to describe the knowledge, understanding, and patient concerns regarding pessary use for management of POP and SUI.

Methods: We performed a qualitative study of women presenting with POP or SUI who were counseled on a pessary at their initial urogynecology visit. Participants completed interviews which were recorded, de-identified, and transcribed. Transcriptions were coded for major themes by two independent researchers. Disagreements were arbitrated by a third member of the research team. Analysis was performed using Dedoose software.

Results: Twenty patients with an average age of 63 +/- 8.5 years participated. Most identified as sexually active (60%) and
Conclusions: Patient opinions about pessaries are often negative with preconceived notions surrounding utilization. Focused counseling addressing concerns and fears may improve a patient’s comfort with a pessary as their choice of treatment modality.