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Factors contributing to long-term vaginal pessary use: A mixed-methods study.

L E Drost1, L Beijleveldt2, B O Ozéphius2

  • 1Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, The Netherlands.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|June 30, 2025
PubMed
Summary
This summary is machine-generated.

Long-term vaginal pessary use for pelvic organ prolapse (POP) is feasible and can become a habit, offering relief from symptoms with little burden. Patients report good quality of life and satisfaction with this treatment option.

Keywords:
mixed methodspatient experiencepelvic organ prolapsepessaryquality of life

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Area of Science:

  • Urogynecology
  • Pelvic Floor Disorders
  • Women's Health

Background:

  • Vaginal pessary therapy is a treatment option for pelvic organ prolapse (POP).
  • Long-term outcomes, quality of life, and psychological well-being associated with pessary use are not well understood.
  • This study investigates factors influencing sustained pessary use in POP patients.

Purpose of the Study:

  • To explore factors contributing to long-term vaginal pessary use in patients with pelvic organ prolapse.
  • To assess the long-term quality of life and psychological well-being of women using pessaries for POP.
  • To identify key themes influencing patient satisfaction and adherence to pessary therapy.

Main Methods:

  • A mixed-methods study involving 35 patients using pessaries for at least 5 years.
  • Quantitative data collected via validated questionnaires on satisfaction, shared decision-making, decisional regret, quality of life, and pelvic floor complaints.
  • Qualitative data gathered through semi-structured interviews analyzed using grounded theory.

Main Results:

  • Patients reported good quality of life and high satisfaction with long-term pessary treatment.
  • Major themes identified: treatment effectiveness, healthcare provider interaction, and patient choice in care.
  • Minor themes included psychosocial aspects, self-image, habit formation, and sexuality.

Conclusions:

  • Long-term pessary use is a viable and sustainable treatment for POP, often becoming a low-burden habit.
  • Healthcare providers should discuss long-term effects, including psychosocial aspects and self-image, with patients considering pessary use.
  • Informed patients can be reassured about the feasibility and benefits of long-term pessary therapy for symptom relief.