Patient experience of pain during vaginal pessary removal and insertion: a service evaluation study

• Published in: International Urogynecology Journal 2024-02, Vol.35 (2), p.327-332
• Main Authors: Renouf, Caitlin, Ballard, Paul, Khunda, Aethele, Kershaw, Victoria, Shawer, Sami, Rees, Jon
• Format: Article
• Language: English
• Subjects: Ambulatory Care Facilities; Colpotomy; Female; Gynecology; Humans; Medicine; Medicine & Public Health; Original Article; Pain; Pain - etiology; Patient Outcome Assessment; Patients; Pessaries - adverse effects; Pregnancy; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-023-05643-w

Introduction and hypothesis Pelvic organ prolapse is a common problem affecting women, but there is currently a lack of research focusing on patient experience of pessary changes. This study was aimed at capturing the patient perspective of pessary changes and formally assessing pain during pessary removal and insertion. Methods A service evaluation request was granted by South Tees Hospitals NHS Trust. Patients undergoing pessary change (ring, shelf, or Gellhorn) in gynaecology outpatient clinics over a 6-month period were asked to rate their pain scores on a ten-point numerical pain-rating scale. Other associated data were collected. Results Out of 213 women, 58.2% reported that pessary removal was more painful than insertion, 30.5% reported equal pain, and 10.8% reported that insertion was more painful than removal. Pain scores were significantly higher for removal (mean 4.37, median 4, IQR 4–7) than for insertion (mean 2.66, median 2, IQR 2–4, p