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International Urogynecology Journal

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Open Access 01-10-2015 | Original Article

A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

Authors: Joost Velzel, Jan Paul Roovers, C H Van der Vaart, Bart Broekman, Astrid Vollebregt, Robert Hakvoort

Published in: International Urogynecology Journal | Issue 10/2015

Abstract

Introduction and hypothesis

To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP).

Methods

A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology.

Results

The response rate was 59 %. Of the respondents, 13 % had a written protocol for pessary treatment in their department. Pessary treatment was proposed by 69 % of respondents as a treatment option. Counseling about side effects varied. All respondents provided information concerning the possibility of serious vaginal discharge. Concerning this side effect, 15 % of the respondents stated that it occurs in 5 – 20 % of patients, 27 % that it occurs in 20 – 40 % of patients, and 57 % that it occurs in more than 40 % of patients. Another item concerned counseling for the likelihood of vaginal blood loss. All respondents provided information concerning the possibility of vaginal blood loss. Concerning this side effect, 53 % of the respondents stated that it occurs in 5 – 20 % of patients, 33 % that it occurs in 20 – 40 %, and 14 % that it occurs in more than 40 % of patients. Follow-up after initial placement was done by 69 % of the respondents at 2 – 6 weeks, by 2 % at 8 weeks, and by 29 % at 12 weeks or more. Most (98 %) of the respondents extended the interval between visits when the patient had no complaints, and 96 % of the respondents reported that they routinely instruct patients about self-management.

Conclusions

Pessaries are suggested as a treatment option by a majority of gynecologists, but practice varies widely. We consider that the variation in practice is due to a lack of available protocols and lack of evidence.

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Title: A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research
Authors: Joost Velzel
Jan Paul Roovers
C H Van der Vaart
Bart Broekman
Astrid Vollebregt
Robert Hakvoort
Publication date: 01-10-2015
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 10/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2697-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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