title: Defining Patient Knowledge and Perceptions of Vaginal Pessaries for Prolapse and Incontinence.
abstract: OBJECTIVE
  The aim of this study was to define patient knowledge and perceptions of pessaries to identify barriers to care and inform physician counseling efforts.
  
  
  METHODS
  An anonymous survey was distributed to a convenience sample of new patients presenting to the urogynecology clinic at a single academic medical center. Data analysis was performed using standard bivariate and logistic regression models.
  
  
  RESULTS
  A total of 254 women completed the survey. Only half of respondents indicated prior knowledge of pessaries. The most common source of prior knowledge was a physician or other health care provider (100/130, 76.9%); comparatively few women had heard about pessaries from any other source. Patients presented with a negative view of pessaries, 3.6 ± 2.2 on a 0- to 10-point Likert scale, and only a third of patients indicated they would consider pessary use as a treatment option for their condition. On multivariable logistic regression, having previously seen a gynecologist (P = 0.03) and a lower level of education (P = 0.05) independently predicted aversion to pessary use.
  
  
  CONCLUSIONS
  Only half of patients presenting to a referral-based practice had previous knowledge of vaginal pessaries. Few patients had heard about pessaries from any source other than a physician or other health care provider. Patients presented with a negative impression of pessaries and a high level of aversion to pessary use. Patients who indicated they would decline pessary use reported a lower level of education and were more likely to have previously seen a gynecologist for evaluation of their condition. These data may inform physician counseling efforts.
authors.affiliation: From the *Department of Obstetrics and Gynecology, and †Division of Gynecology/Urogynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
authors.forename: Lindsay K
authors.initials: LK
authors.lastname: Brown
authors.forename: Dee E
authors.initials: DE
authors.lastname: Fenner
authors.forename: John O L
authors.initials: JO
authors.lastname: DeLancey
authors.forename: Megan O
authors.initials: MO
authors.lastname: Schimpf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000523:psychology / Q000628:therapy*; D010570:Pessaries; D014549:Urinary Incontinence / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
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