Table 5.
Full survey questionnaire
| Topic 1: Characteristics of gynecologists and hospitals | ||
| A] In what type of department do you work? | General hospital | |
| Teaching hospital | ||
| Academic hospital | ||
| Private practice | ||
| B] How many new patients with vaginal prolapse are seen in your clinic annually? | 0 – 200 | |
| 201 – 400 | ||
| 401 – 600 | ||
| 601 – 800 | ||
| >800 | ||
| C] How many vaginal prolapse surgery cases are there in your clinic annually? | 0 – 100 | |
| 101 – 150 | ||
| 151 – 200 | ||
| 201 – 300 | ||
| >300 | ||
| D] How many new patients with incontinence are seen in your clinic annually? | 0 – 25 | |
| 26 – 50 | ||
| 51 – 75 | ||
| 76 – 100 | ||
| >100 | ||
| E] Is there a gynecologist with a special interest in urogynecology employed in your clinic? | Yes | |
| No | ||
| F] Is there a written protocol for pessary use in your clinic? | Yes | |
| No, but consensus between caregivers | ||
| No | ||
| Topic 2: Selection of patients | ||
| A] Do you propose pessary placement as your standard initial treatment? | Yes | |
| Not in some cases | ||
| No | ||
| B] What type of prolapse or complaint is most suitable for pessary treatment (multiple-choice question)? | Prolapse anterior compartment | |
| Prolapse middle compartment | ||
| Prolapse posterior compartment | ||
| Stress incontinence | ||
| Urge incontinence | ||
| Constipation | ||
| Obstructed defecation | ||
| C] Does stage of prolapse influence pessary treatment? | Yes | |
| No | ||
| D] Does patient age influence pessary treatment? | Yes | |
| No | ||
| Topic 3: Follow-up management | ||
| A] What is the interval to the first follow-up after initial placement in weeks? | 2 weeks | |
| 3 weeks | ||
| 4 weeks | ||
| 6 weeks | ||
| 8 weeks | ||
| 12 weeks | ||
| 16 weeks | ||
| B] Which professional is responsible for the first follow-up visit after initial placement | Same caregiver | |
| Same caregiver, later on general practitioner | ||
| Same caregiver or general practitioner | ||
| A specialist nurse | ||
| Patient wishes | ||
| C] Do the intervals between follow-up visits change after initial placement (multiple-choice question)? | Same interval continued | |
| Shorter intervals if complaints | ||
| Longer intervals if no complaints | ||
| D] Do you prescribe estrogens (oral or vaginal use)? | Yes | |
| When indicated (vaginal atrophy) | ||
| When indicated (other than atrophy) | ||
| No | ||
| Topic 4: Information gynecologists provides to patients including the option of self-management | ||
| A] How often does vaginal discharge occur due to pessary treatment for prolapse? | 5 – 20 % | |
| 20 – 40 % | ||
| 40 – 60 % | ||
| 60 – 75 % | ||
| >75 % | ||
| B] How often does vaginal blood loss occur due to pessary treatment for prolapse? | 5 – 20 % | |
| 20 – 40 % | ||
| 40 – 60 % | ||
| 60 – 75 % | ||
| >75 % | ||
| C] What is the average chance on getting surgical treatment for prolapse after pessary treatment? | 0 – 25 % | |
| 25 – 50 % | ||
| 50 – 75 % | ||
| 75 – 100 % | ||
| D] How often does pessary extrusion occur? | 5 – 15 % | |
| 15 – 30 % | ||
| 30 – 50 % | ||
| >50 % | ||
| E] What Information do you give about the chance that pessary treatment will be effective/satisfactory? | 5 – 20 % | |
| 20 – 50 % | ||
| >50 % | ||
| F] Do you give advice on self-management? | Always | |
| Regularly | ||
| No | ||
| G] Do you give instructions on self-management? | Always | |
| Regularly | ||
| No | ||