AI Article Synopsis

  • Pelvic organ prolapse is a common issue among women, and this study aimed to understand patient experiences and pain associated with changing pessaries.
  • During a 6-month evaluation, 213 women reported their pain levels during pessary insertion and removal, revealing that removal was generally more painful, especially with certain types of pessaries.
  • The findings emphasize the need for better patient communication about potential pain and suggest that clinicians should consider pain levels when choosing and advising on different pessary types.

Article Abstract

Introduction And Hypothesis: Pelvic organ prolapse is a common problem affecting women, but there is currently a lack of research focusing on patient experience of pessary changes. This study was aimed at capturing the patient perspective of pessary changes and formally assessing pain during pessary removal and insertion.

Methods: A service evaluation request was granted by South Tees Hospitals NHS Trust. Patients undergoing pessary change (ring, shelf, or Gellhorn) in gynaecology outpatient clinics over a 6-month period were asked to rate their pain scores on a ten-point numerical pain-rating scale. Other associated data were collected.

Results: Out of 213 women, 58.2% reported that pessary removal was more painful than insertion, 30.5% reported equal pain, and 10.8% reported that insertion was more painful than removal. Pain scores were significantly higher for removal (mean 4.37, median 4, IQR 4-7) than for insertion (mean 2.66, median 2, IQR 2-4, p <0.001). Ring pessaries were significantly less painful to both remove and insert than shelf and Gellhorn pessaries. Smaller pessaries were more painful to both remove and insert. There was no significant difference in pain scores reported by those with or without diagnosed vulval conditions.

Conclusions: Pessary removal causes most women moderate pain, which should be communicated to patients beforehand. Ring pessaries are significantly less painful to change than other pessary types. Clinicians should consider pain as a factor in their decision-making surrounding pessary choice and when counselling patients. Future research should focus on ways to reduce pain during pessary removal.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00192-023-05643-wDOI Listing

Publication Analysis

Top Keywords

pessary removal
12
patient experience
8
service evaluation
8
pessary changes
8
pain scores
8
median iqr
8
pessary
6
pain
5
removal
5
experience pain
4

Similar Publications

Robot-Assisted Laparoscopic Sacrohysteropexy with Autologous Fascia Lata.

Int Urogynecol J

December 2024

Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3168, Australia.

Introduction And Hypothesis: Autologous fascia lata has been increasingly utilised in pelvic floor reconstructive surgeries such as sacrocolpopexy and sacrohysteropexy. This case highlights sacrohysteropexy with autologous fascia lata as a promising option for women with advanced uterovaginal prolapse who wish to preserve their uterus and avoid synthetic mesh.

Methods: We report the case of a 65-year-old woman with stage 3 pelvic organ prolapse following one forceps and one spontaneous vaginal delivery.

View Article and Find Full Text PDF

Background: Vaginal pessaries are a common method of managing pelvic organ prolapse (POP), as well as different types of urinary incontinence, allowing patients to successfully improve overall quality of life. Yet despite their positive attributes, there are several reasons why patients may choose to discontinue using pessaries and proceed with surgery to treat their condition instead. This study aimed to explore patients' experiences of pessary use in treating POP.

View Article and Find Full Text PDF

Complications in Pelvic Organ Prolapse With 3-Month Versus 6-Month Pessary Care: Pilot Study.

Urogynecology (Phila)

November 2024

From the Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.

Article Synopsis
  • The study investigates the safety and complications of vaginal pessary use for women with pelvic organ prolapse (POP) by comparing follow-up intervals of 3 months versus 6 months.
  • In this randomized clinical trial, 38 women with advanced POP were divided into two groups to assess the impact of differing cleaning and monitoring frequencies by a healthcare professional.
  • Results showed no significant difference in ulcerations between the groups, but the 6-month group had a higher incidence of bacterial vaginosis, suggesting more frequent follow-up may be beneficial.
View Article and Find Full Text PDF

Objective: Cervical insufficiency accounts for 8 % of preterm births. Pessary and cerclage are considered preventive approaches for preterm birth. These interventions were compared in terms of reducing the prematurity rate in women with previous preterm birth, due to cervical insufficiency or due to having a short cervix in their current pregnancy.

View Article and Find Full Text PDF

Topical lidocaine for pessary removal and reinsertion pain reduction: a randomized clinical trial.

Am J Obstet Gynecol

September 2024

Urogynecology & Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL.

Article Synopsis
  • Vaginal pessaries are a cost-effective, non-surgical option for treating pelvic organ prolapse and stress urinary incontinence, but their maintenance can cause pain.
  • This study aimed to compare the pain-reducing effects of lidocaine HCl 2% jelly to those of standard lubricating jelly during pessary maintenance exams.
  • Conducted as a randomized clinical trial with 66 female participants, the study measured pain levels using a visual analog scale, ultimately assessing if lidocaine HCl jelly provided better pain relief compared to lubricating jelly.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!