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Sunderland Repository records the research produced by the University of Sunderland including practice-based research and theses.

Patient experience of pain during vaginal pessary removal and insertion: a service evaluation study.

Renouf, Caitlin, Ballard, Paul, Khunda, Aethele, Kershaw, Victoria, Shawer, Sami and Rees, Jon (2023) Patient experience of pain during vaginal pessary removal and insertion: a service evaluation study. International Urogynecology Journal, 35. pp. 327-332. ISSN 0937-3462

Item Type: Article


Introduction: Pelvic organ prolapse is a common problem affecting women, but there is currently a lack of research focusing on patient experience of pessary changes. This study aimed to capture the patient perspective of pessary changes and to formally assess pain during pessary removal and insertion.

Methods: A service evaluation request was granted by South Tees Hospitals NHS Trust. Patients undergoing pessary change (ring, shelf, or Gellhorn) in gynaecology outpatient clinics over a six-month period were asked to rate their pain scores on a 10 point numerical-pain-rating-scale. Other associated data was collected.

Results: Out of 213 women, 58.2% reported that pessary removal was more painful than insertion, 30.5% reported equal pain, and 10.8% reported insertion was more painful than removal. Pain scores were significantly higher for removal 4.37 (4, 4-7) than for insertion 2.66 (2, 2-4) [mean (median, IQR), p <.001]. Ring pessaries were significantly less painful to both remove and insert than shelf and Gellhorn pessaries. Smaller pessaries were more painful to both remove and insert. There was no significant difference in pain scores reported by those with or without diagnosed vulval conditions.

Conclusions: Pessary removal causes most women moderate pain, which should be communicated to patients beforehand. Ring pessaries are significantly less painful to change compared to other pessary types. Clinicians should consider pain as a factor in their decision-making surrounding pessary choice and when counselling patients. Future research should focus on ways to reduce pain during pessary removal.

Keywords: Patient experience, Pain, Pelvic-organ prolapse, Pessary changes, Vaginal pessaries

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More Information

Depositing User: Jon Rees


Item ID: 16483
Identification Number:
ISSN: 0937-3462
Official URL:

Users with ORCIDS

ORCID for Aethele Khunda: ORCID iD
ORCID for Jon Rees: ORCID iD

Catalogue record

Date Deposited: 08 Aug 2023 13:42
Last Modified: 23 Apr 2024 12:48


Author: Aethele Khunda ORCID iD
Author: Jon Rees ORCID iD
Author: Caitlin Renouf
Author: Paul Ballard
Author: Victoria Kershaw
Author: Sami Shawer

University Divisions

Faculty of Health Sciences and Wellbeing > School of Psychology


Sciences > Biomedical Sciences
Sciences > Nursing

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