A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research
Open accessAbstract
INTRODUCTION AND HYPOTHESIS: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). METHODS: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. RESULTS: The response rate was 59 %. Of the respondents, 13 % had a written protocol for pessary treatment in their department. Pessary treatment was proposed by 69 % of respondents as a treatment option. Counseling about side effects varied. All respondents provided information concerning the possibility of serious vaginal discharge. Concerning this side effect, 15 % of the respondents stated that it occurs in 5 - 20 % of patients, 27 % that it occurs in 20 - 40 % of patients, and 57 % that it occurs in more than 40 % of patients. Another item concerned counseling for the likelihood of vaginal blood loss. All respondents provided information concerning the possibility of vaginal blood loss. Concerning this side effect, 53 % of the respondents stated that it occurs in 5 - 20 % of patients, 33 % that it occurs in 20 - 40 %, and 14 % that it occurs in more than 40 % of patients. Follow-up after initial placement was done by 69 % of the respondents at 2 - 6 weeks, by 2 % at 8 weeks, and by 29 % at 12 weeks or more. Most (98 %) of the respondents extended the interval between visits when the patient had no complaints, and 96 % of the respondents reported that they routinely instruct patients about self-management. CONCLUSIONS: Pessaries are suggested as a treatment option by a majority of gynecologists, but practice varies widely. We consider that the variation in practice is due to a lack of available protocols and lack of evidence.
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Pathways for pessary management are unclear, and there is variation in what women are offered.
“Pathways for pessary management are unclear and there is variation on what women are offered [47].”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [47]
All international surveys of pessary practice highlight a common theme of pessary practitioners wanting further training in pessary management and a lack of accreditation for training.
“All international surveys of pessary practice highlight a common theme of pessary practitioners wanting further training in pessary management and a lack of accreditation for training [47, 48, 49, 50].”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [47]
The Results and Discussion (page unavailable) describe variation in Dutch pessary practice and a lack of written protocols. They do not report practitioners wanting further training or a lack of training accreditation; searches for those terms found only discussion of training patients in self-management. (LLM, conf=0.73)
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- Authors
- Velzel, J., Roovers, J. P., Van der Vaart, C. H., Broekman, B., Vollebregt, A., & Hakvoort, R.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Sint Franciscus Gasthuis (NL)
- Spaarne Ziekenhuis (NL)
- Corresponding author
- Velzel, Joost
- Venue
- International Urogynecology Journal
- Published
- 2015-06-11
- Volume
- 26
- Issue
- 10
- Pages
- 1453-1458
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- PMC
- PMC4575368
- OpenAlex
- W2108805866
- Cited by
- 18
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 3 · 2016: 1
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- International Urogynecology Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- pessary, pelvic organ prolapse, urogynecology, treatment protocols, vaginal discharge, vaginal bleeding, patient self-management
- MeSH terms
- Female, Gynecology, Humans, Netherlands, Pessaries, Practice Patterns, Physicians', Surveys and Questionnaires, Pelvic Organ Prolapse
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