Pessary Care

Follow Up and Management of Complications

Katharine O'Dell; Shanna Atnip

Disclosures

Urol Nurs. 2012;32(3):126-137, 145. 

In This Article

Conclusion

As the population ages and rates of obesity increase, increasing numbers of women will need care for pelvic floor dysfunctions, including urinary and fecal incontinence and pelvic organ prolapse (Nygaard et al., 2008). Because vaginal support pessaries offer a satisfying, low-risk option for symptom management for many women, a pessary trial should be offered even to women who present with a pre-existing desire for surgery (Clemons, Aguilar, Tillinghast, Jackson, & Myers, 2004). To optimize safe pessary use, providers must be knowledgeable of pessary-related risks and benefits, vigilant in pessary follow up, and prepared to appropriately refer women with pessary-related problems that exceed their scope of practice. In a safe and supported environment, women's satisfaction with pessary use can also be enhanced by clarifying goals of treatment, optimizing individual regimens for use and follow up, and evaluating outcomes based on those goals.

While the evidence base to support successful pessary use has expanded in recent years, much remains to be studied. This includes the comparative safety of follow-up recommendations and the cost-effectiveness of support pessaries versus other prolapse treatment strategies (Adams, Thomson, Maher, & Hagen, 2004). Currently, pessary providers are encouraged to combine their best clinical knowledge and judgment with informed patient preference and expert recommendation to maximize treatment satisfaction with these simple, effective pelvic support devices.

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