(1) Background: Pelvic organ prolapse (POP) can be managed using a vaginal pessary. However, the decision-making process whereby health professionals choose the right pessary is unclear. The objective of this study was to focus on the experience of experts in pessary use and to propose an algorithm. (2) Methods: A prospective study, based on face-to-face semi-directive interviews and group discussions, was conducted on a multidisciplinary panel of professional experts specialized in pessary prescriptions. A consensual algorithm was established, and its accuracy was assessed by expert and non-expert panels. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) were used. (3) Results: 17 semi-directive interviews were conducted. The parameters involved in the decision-making process regarding the choice of vaginal pessaries were: desire for self-management (65%), associated urinary stress incontinence (47%), POP type (41%), and POP stage (29%). The algorithm was developed step by step (4 iterations) using the Delphi technique. Most of the expert panel (76%) rated the relevance of the algorithm as 7 or more out of 10 on a visual analog scale according to their own experience (reference activity). Finally, most (81%) of the non-expert panel (n = 230) rated the usefulness of this algorithm as 7 or more out of 10 on a visual analog scale. (4) Conclusions: This study provides an expert panel-based algorithm that may help in the prescription of pessaries for POP.
Journal of clinical medicine. 2023 Feb 15*** epublish ***
Marie-Amélie Le Quoy, Odile Cotelle, Renaud de Tayrac, Florence Happillon, Antoine Pelhuche, Valérie Wenner-Vidal, Blandine Liagre, Florence Cour, Camille Armengaud, Gautier Chene, Emilie Cerutti, Fabienne Doucet, Anne-Cécile Pizzoferrato, Xavier Deffieux
Service de Gynécologie-Obstétrique, Assistance Publique-Hopitaux de Paris (APHP), GHU Paris Saclay, Hopital Antoine Beclere, 157, rue de La-Porte-de-Trivaux, F-92140 Clamart, France., Service de Gynécologie, CHRU Carémeau, rue du Professeur-Debré, CEDEX 9, F-30029 Nîmes, France., Independent Researcher, 35 Bis Route Corzent, F-74200 Anthy sur Léman, France., Unité D'urodynamique, Assistance Publique-Hopitaux de Paris (APHP), GHU Paris Saclay, Hôpital Paul Brousse, 12 Avenue Paul-Vaillant-Couturier, F-94800 Villejuif, France., Laboratoire D'urodynamique, Hôpital Georges Clémenceau, GHU Paris Est, Assistance Publique-Hopitaux de Paris (APHP), 1 rue Georges-Clemenceau, F-91750 Champcueil, France., Independent Researcher, 120 rue Chanzy, F-59260 Hellemmes, France., Service d'Urologie, Hôpital Foch, 40 rue Worth, F-92150 Suresnes, France., Service de Gynécologie-Obstétrique, Centre Hospitalier Intercommunal de Poissy, 10 rue Champ Gaillard, F-78300 Poissy, France., Department of Gynecology, Hôpital Femme Mère Enfant-HFME, University of Lyon, 59 bd Pinel, F-69500 Bron, France., Service d'Urologie, Andrologie et Transplantation Rénale, CHU Jean Minjoz, F-25000 Besancon, France., Service de Gynécologie-Obstétrique, CHU de Poitiers, 2 rue de la Milétrie, F-86000 Poitiers, France.