Topic:	Kidney and Urologic Diseases (KU)
Title:	Practical Use of the Pessary.
Author:	Viera, A.J.; Larkins-Pettigrew, M.
Source:	American Family Physician. 61(9): 2719-2726. May 1, 2000.
Availability:	Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org.
Abstract:	Although many physicians are unfamiliar with the pessary, it remains an effective tool in the management of a number of gynecologic problems. The article reviews the practical use of the pessary, which is most commonly used in the management of pelvic support defects such as cystocele and rectocele. Pessaries can also be used in the treatment of stress urinary incontinence (SUI). Good candidates for a pessary trial might include a pregnant patient, an elderly woman in whom surgery would be risky, and a woman whose previous operation for stress incontinence failed. The wide variety of pessary styles may cause confusion for physicians during the initial selection of the pessary. However, an understanding of the different styles and their uses will enable physicians to make an appropriate choice. The authors review each type and note their uses; one illustration depicts most of the types in current use. Complications can be minimized with simple vaginal hygiene and regular followup visits. The authors conclude that incorporating the use of the pessary into a physician's practice requires minimal investment; however, it may significantly improve the lifestyle of patients who have limited therapeutic alternatives. 8 figures. 2 tables. 11 references.
Format:	Journal Article
Language:	English.
Major Keywords:	Urologic Diseases. Urinary Incontinence. Equipment and Supplies. Pelvic Floor. Patient Care Management.
Minor Keywords:	Stress Incontinence. Complications. Patient Selection. Vagina. Gynecology. Hygiene.
Publication Number:	KUJA08567
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