Insights into Long-term Pessary Use: An AI-assisted Qualitative Analysis

Objectives: To explore formerly unidentified experiences and motivations associated with long-term pessary use from the patient perspective.

Methods: A qualitative study was conducted through semi-structured phone interviews (n=16) among women currently using a pessary for over 3 years. The interviews were transcribed, de-identified, and analyzed using a generative artificial intelligence large language model to identify recurring themes relating to successful long term pessary use.

Results: Thematic saturation was achieved. We identified 6 primary themes: quality of life improvement, aversion to surgery, routine maintenance schedule, trust and medical support, adjustments and compromises, and information sharing and knowledge gaps. Keys to improving their quality of life were the symptomatic improvements and ability to maintain an active lifestyle. Women often chose the pessary as the alternative to surgery and preferred to have it regularly maintained by their provider. Significant value was placed on trust and good rapport with their provider. Despite some challenges and adjustments, the benefits of pessary use, such as improved lifestyle and autonomy in treatment choice were highlighted.

Conclusions: The themes extracted from this qualitative study provide a nuanced view of various facets of successful long-term pessary use. Overarching themes that emerged highlight the importance of a patient-centered care and the need for providers to recognize the multifaceted concerns and motivations of pessary users. Providers should continue to reassure patients that a pessary can be a very gratifying long-term option as an alternative to surgery for POP treatment.