Patient-selected goal attainment for pessary wearers: what is the clinical relevance?

Objective The purpose of this study was to evaluate whether patient determined goal achievement is associated with pessary continuation. Study Design Patients identified goals they wished to achieve from pessary use. Patients were asked whether they continued pessary use and if goals were met 6-12 months later. Goals were divided into 8 categories. Fisher exact test was used to evaluate categorical variables, t tests for continuous variables, and regression methods to calculate odds ratios (OR). Results Eighty women enrolled in the study. Sixty-four had follow-up data. Goals commonly listed were bladder (36%), activity (20%), general health (13%), and prolapse related (11%). Thirty-four women continued and 30 discontinued pessary use. Women who continued pessary use were more likely to meet 1 or 2 goals (OR 17.5, 21.1 and 95% CI 4.8-64.4, 5.7-78.9, respectively). Conclusion Patient goals are variable and subjective. However, when assessed for achievement, they are associated with pessary continuation. Women who attain self-determined goals are likely to continue pessary use.