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Question answered:03/03/08
We found little direct guidance on this topic.
A Central Lancashire PCT policy [1] suggested following the manufacturers guidance.
An entry in GP Notebook [2] reports:
“This may be used in the treatment of uterine prolapse or stress incontinence. Ring pessaries must be changed regularly - usually every 4-6 months - and before replacement, must be washed and the vagina inspected to exclude trauma.
Ring pessaries are only satisfactory for the lesser degrees of prolapse or for mild stress incontinence.”
Finally, the American Family Physician reports [3]:
“At each follow-up examination, the pessary should be removed and cleaned with soap and water while the vagina is inspected for erosions, pressure necrosis or allergic reaction. If inspection of the pessary reveals cracking or other defects, it should be replaced. The patient who is using a pessary should be considered to be under the care of the person who placed it for the duration of its use. Pessaries should never be placed in elderly, debilitated patients without excellent follow-up.”
References
1) http://www.centrallancashire.nhs.uk/centrallancsPortal/cmsitem?documentPath=lib/DPH%2003%20Decontamination%20Of%20Medical%20Devices%20Policy&version=1
2) http://www.gpnotebook.co.uk/simplepage.cfm?ID=1751842828&linkID=55693
3) http://www.aafp.org/afp/20000501/2719.html
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