ATTITUDES TOWARDS PESSARY USE AMONGTHAI WOMEN WITH PELVIC ORGAN PROLAPSE
M. TREEWIJIT, S. BUNYAVEJCHEVIN;
Ob Gyn, chulalongkorn Univ., BKK, Thailand.
Introduction: Pelvic organprolapse (POP) can be treated with pessary and surgery. Manyguidelines (ACOG, FDA and AUGS) suggested that the pessary should begiven as the first line of treatment for women with POP due to itshigh efficacy, lower cost, fewer complications when compared tosurgical treatment. Many women however, still choose surgicaltreatment over the pessary. Both treatments have different advantagesand disadvantages, which can be judged differently by patients.There are other factors influencing the decision making apartfrom efficacy, cost and complications such as traditional beliefs,culture, family member opinions etc. Literature lacks of a study thatdescribes patient attitudes with POP toward pessary use. It isimportant to understand patient motivation and expectations forpessary use versus prolapse surgery. Such understanding maypotentially lead to improved counseling and increased rate ofpessary
Objective: To investigate the attitudes towardspessary use in Thai women with pelvic organ prolapse (POP).
Methods:Ninety Thai women with symptomatic POP without history of previousprolapse treatment were recruited in an unviersity hospital. After abrief introduction of POP and treatment choices were given,questionnaires to confirm participant understand of content wereprovided. Then, a self-administered questionnaire about attitudestowards pessary use in Thai language were given. Decision choices,patient characteristics and decision making factors wereidentified.
Results: Fifty three women (53.3%) decided touse pessary . Most respondents felt that pessary use would improveemotional status (56.2%), improve pain symptoms (52.0%) and improvequality of life (75%). Family member opinions and post-appliedbleeding, discharge, irritation and pain were important factors indecision making.
Conclusions: Many Thai women with POPprefer pessary. The decision regarding pessary use is influenced byfamily member opinions and complications of pessary. Counseling aboutadvantages and uncommon complications of pessary should be focused toboth patients and family members to improve higher pessaryacceptation.
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3.Female Pelvic Med Reconstr Surg 2011;17:298-301.