OBGYN Department, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA.
OBGYN Department, Denver Health, 777 Bannock St, Denver, CO, 80204, USA.
Int Urogynecol J. 2024 Oct;35(10):1977-1982. doi: 10.1007/s00192-024-05873-6. Epub 2024 Sep 5.
This study surveyed urogynecologists and Advanced Practice Providers (APPs) in the USA to gauge their interest and willingness to embrace customizable pessaries as a viable treatment option. We hypothesize that clinicians might be interested in using customizable pessaries in their practice.
A cross-sectional survey was conducted among urogynecologists and their APPs who fit pessaries to gain insights into their experiences with standard pessaries and perspectives on the value and feasibility of customizable devices. The survey was distributed through email lists associated with women's health and pelvic floor disorders and gathered data on the difficulty in fitting pessaries and the perceived advantages of integrating customizable options into clinical practice.
There were 122 participants, including 76 physicians and 46 APPs. Thirty-five percent of clinicians advocated for pessaries as a first-line therapy for pelvic floor disorders. APPs were more inclined to recommend pessaries as a primary therapy than physicians (p < 0.01). Fifty-three percent of providers reported occasional difficulties, and 12% reported frequent difficulties fitting patients with standard-shaped pessaries. APPs were significantly more likely to encounter fitting issues due to pessary shape (p = 0.023). Clinicians suggested additional practices, such as modifying pessaries to enhance retention in patients with an enlarged genital hiatus, shortened vaginas, or apical narrowing.
This study indicates that clinicians are inclined to incorporate customizable pessaries into their treatment protocols for pelvic floor disorders, emphasizing the need for continued innovation in pessary customization that prioritizes a patient-centric approach to pelvic floor disorder management.
本研究调查了美国的泌尿科医生和高级执业医师(APP),以了解他们对可定制子宫托作为可行治疗选择的兴趣和意愿。我们假设临床医生可能有兴趣在实践中使用可定制子宫托。
对适配子宫托的泌尿科医生及其 APP 进行了横断面调查,以深入了解他们在使用标准子宫托方面的经验,以及对可定制设备的价值和可行性的看法。该调查通过与女性健康和盆底疾病相关的电子邮件列表进行分发,并收集了关于适配子宫托的难度以及将可定制选项纳入临床实践的优势的相关数据。
共有 122 名参与者,包括 76 名医生和 46 名 APP。35%的临床医生提倡将子宫托作为盆底疾病的一线治疗方法。APP 比医生更倾向于将子宫托推荐为主要治疗方法(p<0.01)。53%的提供者报告偶尔有困难,12%的提供者报告经常有困难为标准形状的子宫托适配患者。由于子宫托的形状,APP 遇到适配问题的可能性显著更高(p=0.023)。临床医生建议采取其他措施,例如修改子宫托以增强对生殖器间隙增大、阴道缩短或顶部变窄的患者的保留力。
本研究表明,临床医生倾向于将可定制子宫托纳入其盆底疾病治疗方案,强调需要继续创新子宫托定制,优先考虑以患者为中心的盆底疾病管理方法。