Search

Pelvic organ prolapse and urinary incontinence are common but under-treated conditions in women. Lucy Dwyer explains how to assess and manage the conditions in primary care Pelvic organ prolapse (POP) and urinary incontinence (UI) are extremely common yet under-reported and, therefore, under-treated conditions. Women may disclose symptoms of POP or UI to practice nurses and other healthcare professionals working in primary care. Therefore, this article aims to provide a background to both conditions and explain how to assess and manage POP and UI in primary care, utilising NICE guidelines to ensure practice nurses feel confident in their provision of evidence-based care. [ABSTRACT FROM AUTHOR]

The article focuses on the value of nursing which support to a surgical camp in Uganda. Topics discussed include Birth-Aid is a charity established by a team of urogynaecologists from the Warrell Unit, Saint Mary's Hospital, Manchester in April 2016; and the charity helps women with childbirth injuries by providing surgical treatment and training for local health professionals in the prevention and treatment of future birth injuries.

Pelvic organ prolapse is a significant quality of life issue for many women. Prolapse can be managed effectively with a mechanical device called a pessary therefore many women choose this as a conservative treatment option. Despite the extent to which pessaries are used in the UK, there are no clear guidelines regarding the training required for pessary practitioners. This article reviews literature related to pessary practitioner training. Methods: 13 publications were reviewed. Results: eight themes were identified, namely 'prevalence of pessary training', 'type of pessary training', confidence in pessary care provision', 'impact on pessary care', 'skills and knowledge required to be a pessary practitioner', 'barriers', 'speciality of pessary care providers', and 'ongoing support'. Conclusion: at present practitioners report a lack of pessary training, which impacts on care. Effective training includes didactic learning of agreed knowledge requirements, practice of clinical skills and ongoing support. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic organ prolapse (POP) can be effectively managed using a pessary. A scoping review found that pessary self-management appears to benefit women with no increased risk. Despite this, many are unwilling to self-manage their pessary. At present, there is a lack of understanding about what affects willingness to self-manage a pessary. However, there may be relevant, transferable findings from other literature about barriers to the self-management of other chronic conditions. Therefore, this systematic review aims to identify, appraise and synthesise the findings of published qualitative research exploring the barriers and facilitators to self-management of chronic conditions reported by women., Methods and Analysis: The systematic review will be conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and a guide for the systematic review of qualitative data. A search of MEDLINE, CINAHL, Embase and PsycInfo will be undertaken to identify relevant articles that meet the eligibility criteria using the search terms 'Women', 'Woman' 'Female,' 'Chronic', 'Long-term', 'Disease', 'Illness', 'Condition' 'Health,' 'Self-management,' 'Qualitative,' 'Barrier' and 'Facilitator'. A hand search of the reference list of non-original research identified during the search but excluded will be conducted for additional publications, which meet the inclusion and exclusion criteria. Studies published before 2005 and those not available in English will be excluded. Data relevant to the topic will be extracted and critical appraisal of all included publications undertaken., Ethics and Dissemination: No ethical or Health Research Authority approval is required to undertake the systematic review. The systematic review findings will be disseminated by publication. The findings will also inform subsequent exploratory work regarding pessary self-management., Prospero Registration Number: CRD42022327643., Competing Interests: Competing interests: LD and RK are coapplicants of the NIHR/HTA funded Treatment of Prolapse with Self-Care Pessary study., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Objectives: Pelvic organ prolapse can be managed with a pessary. However, regular follow-up may deter women due to the inconvenience of frequent appointments, as well as preventing autonomous decision making. Pessary self-management may be a solution to these issues. However, there remains a number of uncertainties regarding pessary self-management. This scoping review aims to map available evidence about pessary self-management to identify knowledge gaps providing the basis for future research., Design: Scoping review as detailed in the review protocol., Data Sources: A search of MEDLINE, CINAHL, EMBASE and PsycINFO databases and a handsearch were undertaken during May 2021 to identify relevant articles using the search terms 'pessary' and 'self-management' or 'self-care'., Data Extraction and Synthesis: Data relevant to pessary self-management was extracted and the Mixed Methods Appraisal Tool used to assess empirical rigour. Thematic analysis was performed to evaluate the results., Results: The database search identified 82 publications. After duplicates and articles not meeting the inclusion and exclusion criteria were removed, there were 23 eligible articles. A hand search revealed a further 19 articles, resulting in a total of 42 publications.Findings relevant to pessary self-management were extracted and analysed for the emergence of themes. Recurrent themes in the literature were; the characteristics of self-managing women; pessary care; factors associated with decision making about self-management; teaching self-management and cost benefit., Conclusions: Pessary self-management may offer benefits to some women without increased risk. Some women do not feel willing or able to self-manage their pessary. However, increased support may help women overcome this. Further in-depth exploration of factors which affect women's willingness to self-manage their pessary is indicated to ensure better understanding and support as available for other conditions., Competing Interests: Competing interests: LD and RK are coapplicants of the NIHR/HTA funded Treatment of Prolapse with Self-Care Pessary (TOPSY) study., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)