Effects of Delayed Pessary Maintenance Appointments on Patient's Symptoms and Clinical Findings During the COVID-19...

The COVID-19 pandemic impacted healthcare globally, with significant delays in elective services. This service evaluation aimed to capture the impact of delays in pessary maintenance appointments on patient's symptom experience and clinical findings.

All patients attending routine pessary maintenance appointments over a 6-month period during the COVID-19 pandemic were asked a series of questions concerning vaginal symptoms. Clinician observation of erythema and erosion were recorded. Descriptive statistics, for both total duration in situ and delay in pessary maintenance appointments, were calculated on the basis of pessary type for each symptom.

Of the 208 questionnaires received, 173 were analysed and 35 excluded (incomplete data). Pessary distribution: ring (n = 99), Gellhorn (n = 52), shelf (n = 22). There was a moderate correlation with time pessary in situ and symptoms of discharge and odour in all pessaries, with a weak relationship between symptoms and delay in pessary maintenance appointments. Patients using a pessary longer than 6 months, were unlikely to report worsening symptoms related to delay in pessary maintenance appointments, with the majority reporting no symptom change. Whilst clinician findings of erythema and erosion correlated strongly with duration of pessary use, severe changes were observed when pessaries were in situ at least 11 months.

These findings indicate that in select patients, extending pessary maintenance appointments beyond 6 months may have little effect on patient symptoms but, beyond 10 months risks increasing the incidence of severe erythema and erosion. This can help reduce burden on appointments for both patients and providers and reduce wastage of single use resources.