Understanding Factors That Affect Willingness to Self-Manage a Pessary for Pelvic Organ Prolapse: A Questionnaire-Based Cross-Sectional Study of Pessary-Using Women in the UK
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Introduction and Hypothesis: Pessary self-management offers benefits to women with no increased risk of complications. However, many are unwilling to self-manage, preferring clinician-led care. This study is aimed at exploring factors associated with willingness to self-manage a pessary. Methods: Women attending pessary clinic at a UK hospital were asked to complete a questionnaire providing responses on pessary use, comorbidities, female genital self-image, self-management experience and willingness (or not) to learn self-management. Based upon statistical advice we aimed to recruit 90 women. Data were analysed using the non-parametric Kruskal–Wallis test and Chi-squared test. Free text data were analysed thematically. Results: A total of 89 women completed the questionnaire. Thirty-three women (38%) had previously been taught pessary self-management. Of the remaining women, 12 (21%) were willing to learn, 28 (50%) were not willing and 16 (29%) were unsure. There was no correlation between female genital self-image and willingness to self-manage a pessary. Younger women were more willing to learn self-management (p = < 0.001). Willing women were motivated by reduced follow-up visits. Self-managing women reported benefits including increased autonomy, cleanliness and giving their body “a break”. Reasons discouraging women from self-managing were a lack of confidence; feeling physically unable; wanting clinician-led care; fear of problems or previous problems with their pessary. Conclusions: Most women were either unsure about pessary self-management or unwilling to self-manage. Age was the only factor we found that had a significant relationship with willingness to self-manage a pessary. With robust self-management teaching, support and follow-up, it is likely that many of the barriers women report can be overcome.
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Women who decline self-management report a lack of confidence, feeling physically unable, wanting clinician-led care, and a fear of problems or previous problems with a pessary.
“Women who decline self‐management report a lack of confidence, feeling physically unable, wanting clinician‐led care, and a fear of problems or previous problems with a pessary [45].”
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 [45]
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- Authors
- Dwyer, L., Rajai, A., Dowding, D., & Kearney, R.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- University of Manchester (GB)
- Corresponding author
- Dwyer, Lucy
- Venue
- International Urogynecology Journal
- Published
- 2024-07-02
- Volume
- 35
- Issue
- 8
- Pages
- 1627-1634
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- PMC
- PMC11380633
- OpenAlex
- W4400240885
- Cited by
- 7
- References
- 25
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- International Urogynecology Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (NIHR300519)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- pelvic organ prolapse, female genital self-image, barriers to self-management, patient autonomy
- MeSH terms
- Self-Management, Adult, Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, United Kingdom, Humans, Middle Aged, Pessaries, Surveys and Questionnaires, Self Care, Pelvic Organ Prolapse
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