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- Title
How often should shelf/Gellhorn pessaries be changed? A survey of IUGA urogynaecologists.
- Authors
Khaja, A.; Freeman, R.
- Abstract
Introduction and hypothesis: Gellhorn and shelf pessaries can be effective management for women with pelvic organ prolapse (POP). This study aimed to investigate the opinion of IUGA members about shelf/Gellhorn pessary use, and in particular, how often to change them in patients with POP. There are no evidence-based guidelines available on this subject. Methods: Members of the International Urogynaecology Association (IUGA) and the British Society of Urogynaecology (BSUG) were sent a single electronic mailing of semi-structured questionnaires containing closed and open questions and free text response boxes. The internet-based survey consisted of 13 questions. Free text responses were analysed using a thematic qualitative analysis. Results: A total of 322 respondents from the IUGA membership participated in the survey. Most consider shelf/Gellhorn pessaries an effective first-line treatment for their patients with POP. Self care is usually acceptable with ring pessaries, but with shelf/Gellhorn, 35 % would like to change them every 3 months, 31 % every 6 months and the rest varied. The routine use of oestrogens along with shelf/Gellhorn pessaries is a common practice. The risk of urogenital fistulae is well documented, but overall clinicians felt that shelf/Gellhorn pessaries are a safe and effective treatment for POP. Conclusions: This study highlights the wide variation in global practice of the management of shelf/Gellhorn pessaries for POP. In order to inform our practice, evidence-based guidelines are required. A randomised control trial may help to decide whether or not it is appropriate to change the shelf/Gellhorn pessaries at all.
- Subjects
PESSARIES; PELVIC organ prolapse; MEDICAL societies; HEALTH surveys; UROGYNECOLOGY
- Publication
International Urogynecology Journal, 2014, Vol 25, Issue 7, p941
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-014-2329-6