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Self-care Pessary Management and Factors Associated With Long-Term Pessary Use
Lucy Olson1, Heather Winn2, Irene Morcuende3
1Carver College of Medicine, University of Iowa, Iowa City, IA.
Urogynecology (Philadelphia, Pa.)
|April 13, 2026
Summary
Most patients with pelvic organ prolapse (POP) can self-manage pessaries effectively. Long-term pessary use depends on patient factors, not the management strategy (self-care vs. office-based care).
Area of Science:
- Urogynecology
- Pelvic Floor Disorders
- Medical Device Management
Background:
- Limited evidence exists on predictors and complications of long-term pessary use.
- Outcomes may vary significantly based on management strategy.
Purpose of the Study:
- Compare outcomes of pessary self-care (SC) versus office-based care (OC).
- Identify factors associated with long-term pessary use in patients with pelvic organ prolapse (POP).
Main Methods:
- Retrospective cohort study of 275 patients with POP using pessaries for >3 months (2008-2017).
- Patients classified by management strategy (SC vs. OC) and duration of use.
- Bivariable and multivariable analyses compared characteristics, complications, and discontinuation reasons.
Main Results:
- Majority (77%) performed SC; SC users were healthier, younger, and more sexually active.
- SC users had fewer vaginal erosions and office visits (P<0.001).
- Pessary duration was associated with patient age (longer use) and pulmonary disease (shorter use), but not management type.
Conclusions:
- Most patients can successfully self-manage pessaries for POP.
- Long-term pessary use duration is linked to patient characteristics, not the management approach.
- Pessary self-care appears safe and effective, reducing complications and healthcare utilization.
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