Pessaries in Clinical Practice (eBook)

Scott A. Farrell (Herausgeber)

eBook Download: PDF

2007 | 2007
IX, 98 Seiten
Springer London (Verlag)
978-1-84628-315-4 (ISBN)

Infos

This book provides a comprehensive review of the evidence concerning pessaries and the practicalities of using them. It is a valuable resource for health care practitioners treating patients with incontinence and prolapse. It includes a brief history of pessaries and provides profiles of the inventors of some of the more commonly used pessaries, along with a description of their original purposes. There are illustrations to guide selection, fitting and care, as well as providing materials which can be photocopied and handed out to patients. This work is an essential handbook for all urogynecologists, urologists, gynecologists, family physicians and specialty nurses.

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A valuable resource for the health care practitioner treating patients with incontinence and prolapse, Pessaries in Clinical Practice provides a comprehensive review of the evidence concerning pessaries and the practicalities of using them. With a brief history of pessaries, the authors provide profiles of the inventors of some of the more commonly used pessaries along with a description of their original purposes. The body of the book gives evidence supporting use of pessaries for pelvic organ prolapse and incontinence. It goes on to discuss the practical issues involved with the selection, fitting and care of the most popular pessaries. A significant proportion of the book contains illustrations to guide selection, fitting and care as well as providing materials which could be photocopied to be handed out to patients. This work is an essential quick-reference handbook for all urogynecologists, urologists, gynecologists, family physicians and specialty nurses.

Inhalt

Preface 6
Contents 8
Contributors 9
Chapter 1 The History of Pessaries for Uterovaginal Prolapse --- Thomas F. Baskett 10
Chapter 2 Pessaries for Pelvic Organ Prolapse: The Evidence --- Sandra A. Baydock 19
2.1 OUTLINE 19
2.2 INTRODUCTION 19
2.3 PREDICTORS OF SUCCESSFUL FITTING 19
2.3.1 Patient Preference for a Pessary 19
2.3.2 Patient Factors Influencing Fitting Success 20
2.3.3 Patient Satisfaction and Relief of Prolapse Symptoms 20
2.4 PREDICTORS OF CONTINUED PESSARY USE 21
2.5 APPLICATION OF PESSARY DESIGNS TO SPECIFIC PELVIC SUPPORT DEFECTS 22
2.6 COMPLICATIONS OF PESSARY USE 22
2.7 PESSARY FOLLOW-UP 22
2.8 CURRENT PESSARY USE AMONG HEALTHCARE PROFESSIONALS 23
2.9 SUMMARY AND REVIEW OF KEY POINTS 24
KEY POINTS 24
References 24
Chapter 3 Pessaries for the Management of Urinary Incontinence: The Evidence --- Baharak Amir-Khalkhali 26
3.1 OUTLINE 26
3.2 PREVALENCE OF URINARY INCONTINENCE 26
3.3 PATHOPHYSIOLOGY OF STRESS INCONTINENCE 27
3.4 EFFECTIVENESS OF PESSARIES FOR THE MANAGEMENT OF STRESS INCONTINENCE 28
3.5 PREDICTORS OF SUCCESSFUL CONTINENCE PESSARY FITTING 30
3.6 PATIENT SATISFACTION AND RELIEF OF INCONTINENCE 30
3.7 COMPLICATIONS AND REASONS FOR DISCONTINUATION OF A CONTINENCE PESSARY 31
3.8 SUMMARY AND REVIEW OF KEY POINTS 31
KEY POINTS 31
References 32
Chapter 4 Selection of a Patient for Pessary Care --- Scott A. Farrell 34
4.1 OUTLINE 34
4.2 INTRODUCTION 34
4.3 EVALUATION OF THE PATIENT PRIOR TO PESSARY FITTING 35
4.4 DEVELOPING A MANAGEMENT PLAN 38
4.5 SUMMARY AND REVIEW OF KEY POINTS 39
KEY POINTS 39
References 40
Chapter 5 Selection of Pessaries for Pelvic Organ Prolapse --- Sandra A. Baydock and Scott A. Farrell 41
5.1 OUTLINE 41
5.2 INTRODUCTION 41
5.3 EVIDENCE FROM CLINICAL TRIALS 43
5.4 CLINICAL INDICATIONS FOR PESSARY USE 43
5.4.1 Prolapse Without Urinary Incontinence 43
5.4.2 Prolapse with Either Latent or Concurrent Urinary Incontinence 43
5.5 FEASIBILITY OF PESSARY USE (BOTH PATIENT AND PHYSICIAN COMFORT) 44
5.5.1 Ring Pessary 44
5.5.2 Gellhorn Pessary 44
5.5.3 Shaatz Pessary 47
5.5.4 Donut Pessary 47
5.5.5 Cube Pessary 49
5.5.6 Inflatoball 50
5.5.7 Gehrung Pessary 51
5.5.8 Lever Pessaries (Smith, Hodge, and Risser) 51
5.5.9 Double Pessaries 53
5.6 POTENTIAL FOR COMPLICATIONS 53
5.7 DESIRE FOR SEXUAL ACTIVITY 53
5.8 SUMMARY AND REVIEW OF KEY POINTS 53
KEY POINTS 54
References 54
Chapter 6 Selection of Pessaries for Urinary Incontinence --- Baharak Amir-Khalkhali and Scott A. Farrell 55
6.1 OUTLINE 55
6.2 INTRODUCTION 55
6.3 TYPES OF CONTINENCE PESSARIES 58
6.3.1 Incontinence Ring 58
6.3.2 Ring Pessary with Knob 59
6.3.3 Uresta Continence Pessary 59
6.3.4 Incontinence Dish 60
6.3.5 Other Continence Pessaries 60
6.4 OTHER PESSARY ALTERNATIVES FOR STRESS INCONTINENCE 60
6.5 GUIDELINES FOR SELECTION OF A CONTINENCE PESSARY 60
6.6 SUMMARY AND REVIEW OF KEY POINTS 61
KEY POINTS 61
References 61
Chapter 7 Fitting and Care of Pessaries for Pelvic Organ Prolapse --- Sandra A. Baydock and Scott A. Farrell 63
7.1 OUTLINE 63
7.2 PREPARATIONS FOR PESSARY FITTING 63
7.3 PELVIC EXAMINATION AND PESSARY SIZING 63
7.4 PESSARY INSERTION AND TESTING 64
7.5 FITTING INSTRUCTIONS FOR SPECIFIC PESSARIES 65
7.5.1 Ring and Ring with Support: Insertion 65
7.5.2 Ring and Ring with Support: Removal 68
7.5.3 Gellhorn Pessary: Insertion 69
7.5.4 Gellhorn Pessary: Removal 73
7.5.5 Cube Pessary: Insertion 73
7.5.6 Cube Pessary: Removal 75
7.5.7 Donut Pessary: Insertion 75
7.5.8 Donut Pessary: Removal 77
7.5.9 Lever Pessaries: Insertion 77
7.5.10 Lever Pessaries: Removal 78
7.6 SUMMARY AND REVIEW OF KEY POINTS 78
KEY POINTS 78
Chapter 8 Fitting and Care of Continence Pessaries --- Baharak Amir-Khalkhali and Scott A. Farrell 79
8.1 OUTLINE 79
8.2 INTRODUCTION 79
8.3 GENERAL PRINCIPLES OF CONTINENCE PESSARY FITTING 79
8.4 INCONTINENCE RING PESSARY: INSERTION 80
8.5 INCONTINENCE RING: REMOVAL 82
8.6 TROUBLESHOOTING FOR THE INCONTINENCE RING 83
8.7 INCONTINENCE DISH 83
8.8 RING PESSARY WITH KNOB: INSERTION 83
8.9 RING PESSARY WITH KNOB: REMOVAL 86
8.10 URESTA PESSARY: INSERTION 86
8.11 URESTA PESSARY: REMOVAL 88
8.12 TROUBLESHOOTING FOR THE URESTA PESSARY 88
8.13 SUMMARY AND REVIEW OF KEY POINTS 89
KEY POINTS 89
Chapter 9 Patient Education Regarding Pessary Care --- Karen D. Farrell, Linda E. Irving, Jane E. Twohig, and Joan M. Foren 90
9.1 OUTLINE 90
9.2 INTRODUCTION 90
9.3 GUIDELINES FOR WOMEN AT TIME OF INITIAL PESSARY FITTING 91
9.3.1 Schedule of Pessary Visits 91
9.3.2 Pessary Care 91
9.3.3 Pessary Fit 92
9.3.4 Pessary Insertion and Removal 93
9.4 FIRST FOLLOW-UP VISIT 94
9.5 TROUBLE-SHOOTING GUIDE: POTENTIAL PROBLEMS AND THEIR SOLUTIONS 94
9.5.1 Difficulty Removing Pessary 94
9.5.2 Pessary Falls Out 94
9.5.3 Discomfort Using Pessary 94
9.5.4 Pelvic Pain 95
9.5.5 Vaginal Discharge or Odor 95
9.5.6 Vaginal Bleeding 95
9.5.7 Leaking from the Bladder 96
9.5.8 General Advice to Patients Regarding Pessaries 96
9.6 FREQUENTLY ASKED QUESTIONS 97
9.6.1 Do I Have to Remove My Own Pessary? How Often Must I Take It Out? 97
9.6.2 How Does the Pessary Work? Will It Affect My Ability to Pee or Have a Bowel Movement? 97
9.6.3 Can I Have Sex with the Pessary In? 97
9.6.4 Does It Go Anywhere Else in My Body? Can I Put It in the Wrong Place? 98
9.6.5 Will the Pessary Cause Infection? 98
9.6.6 What Do I Do If the Pessary Falls Out or I Can’t Get It Out? 98
9.6.7 Will a Pessary Hurt? Will I Feel It? 98
9.6.8 How Often Will I Need a New Pessary? 98
9.6.9 What Do I Do If My Pessary Is Not Helping My Bladder? 99
9.7 SUMMARY 99
Glossary 100
Index 104

Produkt-Details

• Erscheint lt. Verlag: 6.3.2007
• Zusatzinfo: X, 102 p. 54 illus.
• Verlagsort: London
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Allgemeinmedizin
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Gynäkologie / Geburtshilfe
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Pharmakologie / Pharmakotherapie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Urologie
• Schlagworte: Care • incontinence • Management • Pelvic Organ Prolapse • Pessaries • Stress • Urinary Incontinence
• ISBN-10: 1-84628-315-9 / 1846283159
• ISBN-13: 978-1-84628-315-4 / 9781846283154