Attitudes toward conservative management of pelvic organ prolapse and stress urinary incontinence with vaginal pessaries: A national survey among Israeli obstetricians and gynecologists

Objective: To explore the views of Israeli gynecologists regarding the use of vaginal pessaries for management of pelvic organ prolapse (POP) and stress urinary incontinence (SUI), which are common medical conditions that affect women and can significantly impact their quality of life. Methods: An electronic survey containing questions assessing knowledge, training, and attitudes regarding the use of vaginal pessaries for POP and SUI was distributed among Israeli gynecologists. Data were collected and recorded anonymously. Descriptive statistics were used to summarize the responses. Results: A total of 700 emails were sent, with a response rate of 53% (371 responses). The majority of respondents (76.4%, n = 283) consulted a urogynecologist before and after fitting a pessary; however, 60.4% (n = 224) felt that any gynecologist should be able to follow up on such cases. When stratified by years of experience, physicians with fewer than 10 years of experience were more likely to offer pessary treatment (31.6%, n = 117 vs. 19.1%, n = 71, P < 0.01). However, those who did not offer pessaries felt more uncertain about fitting them and were more likely to report a lack of experience (24.8%, n = 92 vs. 13.6%, n = 50, P < 0.01, and 18.0%, n = 67 vs. 6.2%, n = 23, P < 0.01, respectively). Conclusions: Our survey highlights a gap in knowledge and training among Israeli gynecologists regarding the conservative management of POP and SUI with vaginal pessaries. There is a clear desire among physicians to acquire these skills. The establishment of formal training programs is crucial to bridging this gap and improving women's health outcomes.