E-Posters-10253

10253_Swenson

Pdf Summary

The aim of this study was to determine the rate of documentation of pessary counseling prior to hysterectomies done for pelvic organ prolapse (POP) and identify variables associated with women being offered a pessary. The data used was from the Michigan Surgical Quality Collaborative (MSQC), which collects perioperative data through chart reviews. The study included 3,138 hysterectomies for POP at 62 hospitals, with 3,000 hysterectomies included in the final analysis at 47 hospitals.<br /><br />The results showed that surgery for POP is common, and women considering treatment for POP should be offered a vaginal pessary as an alternative to surgery, as recommended by ACOG and AUGS. However, there was wide variation in pessary counseling prior to hysterectomy, with only a quarter of cases having documentation of pessary counseling. This indicates a need for improvement in the documentation and counseling for pessary use as an initial management option for prolapse.<br /><br />Factors associated with the offer of a pessary included age, tobacco use, prior pelvic surgery, insurance status, hysterectomy approach, teaching hospital status, and hospital bedsize greater than 500. The average rate of pessary offer was 25.1%, but there was significant variation among hospitals, ranging from 2.9% to 75.8%.<br /><br />In conclusion, this study highlights the variation in pessary counseling prior to surgery for pelvic organ prolapse and the opportunity for improvement in the documentation and counseling for pessary use. It suggests the need for standardized guidelines and protocols to ensure that women are offered all appropriate treatment options for POP, including the use of a pessary.

Keywords

pessary counseling

hysterectomies

pelvic organ prolapse

perioperative data

vaginal pessary

prolapse management

factors associated with pessary offer

variation in pessary offer

standardized guidelines

treatment options