Cheau Ying YOONG, Melanie DEMBINSKY, Rohna KEARNEY, Suzanne HAGEN, Carol BUGGE, Aethele KHUNDA
Pelviperineology - 2026;45(2):53-57
This project aims to evaluate the obstacles, as viewed by specialists affiliated to the British Society of Urogynaecology (BSUG), in implementing pessary self-management for women with pelvic organ prolapse. A 7-item survey was sent to 466 members of BSUG by e-mail. Data were collected on unit demographics and obstacles to the wider adoption of self-management of pessaries. We received 88 responses. Of those, 15/88 respondents (16.9%) did not have an urogynaecology nurse and 13/88 (14.8%) had no regular nurse-led pessary clinic. However, 47/88 (53%) stated that they see at least 3 patients who are suitable for pessary self-management per week, but only 39/88 (44%) offer self-management tuition for more than half of their suitable patients. Pessary self-management was more likely to be offered to at least 20% of eligible patients in units with 3 or more urogynaecology nurses compared to units with none (16/22 versus 5/15, p=0.0176) and in units with a regular nurse led clinic compared to those without (47/75 vs. 4/13, p=0.031). The top three challenges in expanding pessary self-management tuition were: Lack of human resources, lack of patient engagement or suitability and lack of clinic time. The majority stated that main barriers could be overcome with adequate clinic time to address patient concerns and encourage them to try changing their own pessary. A significant number of patients who are suitable for pessary self-management are currently receiving clinic-based care. Research is necessary to further evaluate the cultural and organisational barriers to wider utilisation of self-management of pessaries.
