References

Abdel-Fattah M, Familusi A, Fielding S, Ford J, Bhattacharya S. Primary and repeat surgical treatment for female pelvic organ prolapse and incontinence in parous women in the UK: a register linkage study. BMJ Open. 2011; 1:(2) https://doi.org/10.1136/bmjopen-2011-000206

Evaluation of vaginal pessary use by South African gynaecologists. 2011. http://www.sajog.org.za/index.php/SAJOG/article/view/386

Atnip SD. Pessary use and management for pelvic organ prolapse. Obstet Gynecol Clin North Am. 2009; 36:(3)541-563 https://doi.org/10.1016/j.ogc.2009.08.010

Barnsley L, Lyon PM, Ralston SJ Clinical skills in junior medical officers: a comparison of self-reported confidence and observed competence. Med Educ. 2004; 38:(4)358-367 https://doi.org/10.1046/j.1365-2923.2004.01773.x

Baxter P, Norman G. Self-assessment or self deception? A lack of association between nursing students' self-assessment and performance. J Adv Nurs. 2011; 67:(11)2406-2413 https://doi.org/10.1111/j.1365-2648.2011.05658.x

Bugge C, Hagen S, Thakar R. Vaginal pessaries for pelvic organ prolapse and urinary incontinence: a multiprofessional survey of practice. Int Urogynecol J Pelvic Floor Dysfunct. 2013; 24:(6)1017-1024 https://doi.org/10.1007/s00192-012-1985-7

Christakis MK, Shore EM, Pulver A, McDermott CD. Female pelvic medicine and reconstructive surgery in Canada: A survey of obstetrician-gynecologists and urologists. Female Pelvic Med Reconstr Surg. 2017; 23:(3)195-203 https://doi.org/10.1097/SPV.0000000000000360

Dwyer L, Kearney R. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology and Reproductive Medicine. 2018; 28:(1)15-21 https://doi.org/10.1016/j.ogrm.2017.10.005

Simulation training on a vaginal vault model to educate residents in pessary placement for pelvic organ prolapse: a pilot study. https://augs.digitellinc.com/augs/sessions/3280/view

Gorti M, Hudelist G, Simons A. Evaluation of vaginal pessary management: A UK-based survey. J Obstet Gynaecol. 2009; 29:(2)129-131 https://doi.org/10.1080/01443610902719813

Haylen BT, Maher CF, Barber MD An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J Pelvic Floor Dysfunct. 2016; 27:(2)165-194 https://doi.org/10.1007/s00192-015-2932-1

Hooper GL, Atnip S, O'Dell K. Optimal pessary care: a modified Delphi consensus study. J Midwifery Womens Health. 2017; 62:(4)452-462 https://doi.org/10.1111/jmwh.12624

International Centre for Allied Health Evidence. Guidelines for use of support pessaries for women with pelvic organ prolapse. 2012. http://tinyurl.com/y5gqbp2s (accessed 23 April 2019)

Kandadai P, McVay S, Larrieux JR, O'Dell K. Knowledge and comfort with pessary use. Female Pelvic Med Reconstr Surg. 2016; 22:(6)491-496 https://doi.org/10.1097/SPV.0000000000000322

Kassis N, Hale DS, Heit M. A survey of obstetrics and gynecology residents assessing perception of training and knowledge regarding pessaries. J Minim Invasive Gynecol. 2014; 21:(2)S41-S42 https://doi.org/10.1016/j.jmig.2013.12.065

Lone F, Thakar R, Sultan AH. One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires. Int Urogynecol J Pelvic Floor Dysfunct. 2015; 26:(9)1305-1312 https://doi.org/10.1007/s00192-015-2686–9

Lough K, Hagen S, McClurg D, Pollock A Shared research priorities for pessary use in women with prolapse: results from a James Lind Alliance Priority Setting Partnership. BMJ Open. 2018; 8:(4) https://doi.org/10.1136/bmjopen-2017-021276

McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does Simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011; 86:(6)706-711 https://doi.org/10.1097/ACM.0b013e318217e119

Medicines and Healthcare products Regulatory Agency. Managing medical devices: guidance for healthcare and social services organisations. 2015. http://tinyurl.com/ydf5p33b (accessed 23 April 2019)

Minassian VA, Ross S, Lovatsis D, Al-Badr A, Drutz H. Urogynecology experience in Canada's obstetrics and gynecology residency programs. International Urogynaecology Journal. 2004; 15:(5)331-335 https://doi.org/10.1007/s00192-004-1177-1

Neumann PB, Scammell AE, Burnett AM, Thompson JA, Briffa NK. Training of Australian health care providers in pessary management for women with pelvic organ prolapse: outcomes of a novel program. Australian & New Zealand Continence Journal. 2015; 21:(1)6-12

O'Dell K, Wooldridge LS, Atnip S. Managing a pessary business. Urol Nurs. 2012; 32:(3)138-145 https://doi.org/10.7257/1053-816X.2012.32.3.138

O'Dell K, Atnip S, Hooper G, Leung K. Pessary practices of nurse-providers in the united states. Female Pelvic Med Reconstr Surg. 2016; 22:(4)261-266 https://doi.org/0.1097/SPV.0000000000000268

Pott-Grinstein E, Newcomer JR. Gynecologists' patterns of prescribing pessaries. J Reprod Med. 2001; 46:(3)205-208

Qureshi NS, Appleton F, Jones AB. Ring Pessary Sizer: a pilot study to objectively measure size of a ring pessary required by a patient. Gynecol Surg. 2008; 5:(3)247-249 https://doi.org/10.1007/s10397-007-0365-7

Schneider KM, Monga M. Former-resident self-assessment: a tool for residency program curriculum evaluation in obstetrics and gynecology. J Reprod Med. 2005; 50:(11)821-823

Velzel J, Roovers JP, Van der Vaart CH, Broekman B, Vollebregt A, Hakvoort R. A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research. Int Urogynecol J Pelvic Floor Dysfunct. 2015; 26:(10)1453-1458 https://doi.org/10.1007/s00192-015-2697-6

Wilson M, Bellefeuille L, D'Amore A, Mitchell EKL. Establishing a continence nurse-led pessary clinic as a new model of care for women in rural Victoria. Australian & New Zealand Continence Journal. 2015; 21:(3)75-83

A review of pessary for prolapse practitioner training

09 May 2019
Volume 28 · Issue 9

Abstract

Pelvic organ prolapse is a significant quality of life issue for many women. Prolapse can be managed effectively with a mechanical device called a pessary therefore many women choose this as a conservative treatment option. Despite the extent to which pessaries are used in the UK, there are no clear guidelines regarding the training required for pessary practitioners. This article reviews literature related to pessary practitioner training. Methods: 13 publications were reviewed. Results: eight themes were identified, namely ‘prevalence of pessary training’, ‘type of pessary training’, confidence in pessary care provision’, ‘impact on pessary care’, ‘skills and knowledge required to be a pessary practitioner’, ‘barriers’, ‘speciality of pessary care providers’, and ‘ongoing support’. Conclusion: at present practitioners report a lack of pessary training, which impacts on care. Effective training includes didactic learning of agreed knowledge requirements, practice of clinical skills and ongoing support.

Pelvic organ prolapse is defined as the downward displacement of the uterus and/or different vaginal compartments as well as the bladder or bowel (Haylen et al, 2016). Prolapse is a debilitating condition that can cause bowel and bladder symptoms as well as affecting sexual function, quality of life and body image (Haylen et al, 2016). In the UK, the lifetime risk of a woman requiring a procedure to treat prolapse is 10% (Abdel-Fattah et al, 2011). As some women are not bothered by prolapse and others either do not seek treatment or opt for conservative management, the true prevalence of the condition is unknown (Abdel-Fattah et al, 2011). Women seeking prolapse treatment are likely to be offered surgical or conservative management. Conservative management options include lifestyle advice, pelvic floor muscle retraining, support underwear, oestrogen therapy and pessaries (Dwyer and Kearney, 2018). Of conservative management options, pessaries have been demonstrated to be comparable to prolapse surgery for quality of life, urinary symptoms, vaginal symptoms and sexual function (Lone et al, 2015).

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