Pessaries in Clinical Practice

Cover......Page 1
Front Matter......Page 2
Preface......Page 5
Contents......Page 7
Contributors......Page 8
The History of Pessaries for Uterovaginal Prolapse......Page 9
Pessaries for Pelvic Organ Prolapse: The Evidence......Page 17
Patient Preference for a Pessary......Page 18
Patient Satisfaction and Relief of Prolapse Symptoms......Page 19
Predictors of Continued Pessary Use......Page 20
Pessary Follow-up......Page 21
Current Pessary Use Among Healthcare Professionals......Page 22
References......Page 23
Pessaries for the Management of Urinary Incontinence: The Evidence......Page 24
Prevalence of Urinary Incontinence......Page 25
Pathophysiology of Stress Incontinence......Page 26
Effectiveness of Pessaries for the Management Of Stress Incontinence......Page 27
Patient Satisfaction and Relief of Incontinence......Page 29
Summary and Review of Key Points......Page 30
References......Page 31
Introduction......Page 33
Evaluation of the Patient Prior to Pessary Fitting......Page 34
Developing a Management Plan......Page 37
Summary and Review of Key Points......Page 38
References......Page 39
Introduction......Page 40
Prolapse with Either Latent or Concurrent Urinary Incontinence......Page 42
Gellhorn Pessary......Page 43
Donut Pessary......Page 46
Cube Pessary......Page 48
Inflatoball......Page 49
Lever Pessaries (Smith, Hodge, and Risser)......Page 50
Summary and Review of Key Points......Page 52
References......Page 53
Introduction......Page 54
Ring Pessary with Knob......Page 57
Uresta Continence Pessary......Page 58
Guidelines For Selection of a Continence Pessary......Page 59
References......Page 60
Pelvic Examination and Pessary Sizing......Page 62
Pessary Insertion and Testing......Page 63
Ring and Ring with Support: Insertion......Page 64
Ring and Ring with Support: Removal......Page 67
Gellhorn Pessary: Insertion......Page 68
Cube Pessary: Insertion......Page 72
Donut Pessary: Insertion......Page 74
Lever Pessaries: Insertion......Page 76
Summary and Review of Key Points......Page 77
General Principles of Continence Pessary Fitting......Page 78
Incontinence Ring Pessary: Insertion......Page 79
Incontinence Ring: Removal......Page 81
Ring Pessary With Knob: Insertion......Page 82
Uresta Pessary: Insertion......Page 85
Troubleshooting for the Uresta Pessary......Page 87
Summary and Review of Key Points......Page 88
Introduction......Page 89
Pessary Care......Page 90
Pessary Fit......Page 91
Pessary Insertion and Removal......Page 92
Discomfort Using Pessary......Page 93
Vaginal Bleeding......Page 94
General Advice to Patients Regarding Pessaries......Page 95
Can I Have Sex with the Pessary In?......Page 96
How Often Will I Need a New Pessary?......Page 97
Summary......Page 98
Glossary......Page 99
Index......Page 102