Examining Pessary Use and Satisfaction in Managing Pelvic Organ Prolapse: Results From a Cross-Sectional Multicentre Patient Survey

Abstract 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 examine the factors associated with successful and unsuccessful pessary fittings, explore ideal characteristics of a pessary from a patient's perspective, and explore patients' experiences of pessary use in treating POP. Methods Participants completed an online survey regarding pessary use and ideal characteristics of a pessary. Participants were recruited from social media advertisements, online support groups for women’s health-related conditions, and pelvic floor clinics. Results A total of 100 participants were recruited, of which 77 fully completed the survey. Respondents cited pelvic pain, excess vaginal discharge and odor, as well as difficulty with pessary placement as the most common issues related to pessary use. Easy insertion, removal, and relief from side effects were the most commonly reported ideal characteristics for pessary use. Conclusion Patients had important concerns with pessary use and a high number either stopped or were considering stopping even when it improved their POP. Whilst pessaries can help in the management of POP, further improvement is warranted to increase pessary use, such as through the development of user-friendly designs, or applicators to aid with fitting.