What is known from the existing literature about self-management of pessaries for pelvic organ prolapse? A scoping review

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: Pelvic organ prolapse can be managed with a pessary. However, regular follow-up may deter women due to the inconvenience of frequent appointments, as well as preventing autonomous decision making. Pessary self-management may be a solution to these issues. However, there remains a number of uncertainties regarding pessary self-management. This scoping review aims to map available evidence about pessary self-management to identify knowledge gaps providing the basis for future research.

DESIGN: Scoping review as detailed in the review protocol.

DATA SOURCES: A search of MEDLINE, CINAHL, EMBASE and PsycINFO databases and a handsearch were undertaken during May 2021 to identify relevant articles using the search terms 'pessary' and 'self-management' or 'self-care'.

DATA EXTRACTION AND SYNTHESIS: Data relevant to pessary self-management was extracted and the Mixed Methods Appraisal Tool used to assess empirical rigour. Thematic analysis was performed to evaluate the results.

RESULTS: The database search identified 82 publications. After duplicates and articles not meeting the inclusion and exclusion criteria were removed, there were 23 eligible articles. A hand search revealed a further 19 articles, resulting in a total of 42 publications.Findings relevant to pessary self-management were extracted and analysed for the emergence of themes. Recurrent themes in the literature were; the characteristics of self-managing women; pessary care; factors associated with decision making about self-management; teaching self-management and cost benefit.

CONCLUSIONS: Pessary self-management may offer benefits to some women without increased risk. Some women do not feel willing or able to self-manage their pessary. However, increased support may help women overcome this. Further in-depth exploration of factors which affect women's willingness to self-manage their pessary is indicated to ensure better understanding and support as available for other conditions.

Original languageEnglish
Pages (from-to)e060223
JournalBMJ Open
Issue number7
Early online date18 Jul 2022
Publication statusPublished - 18 Jul 2022


  • Female
  • Humans
  • Pelvic Organ Prolapse/therapy
  • Pessaries
  • Self-Management


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