The course is evidence informed but also very clinically focused, to give you the ability to step into the role of fitting pessaries immediately with all the information and support you need and feel clinically confident by the end of the course.

Pelvic organ prolapse prevalence, risk factors, and incidence will be reviewed, and we will break down how different POP presentations affect your pessary selection.

We will discuss other conservative management strategies such as lifestyle changes/modifications, pelvic floor training, weight loss, and bowel and bladder health. Surgical options for pelvic organ prolapse will be reviewed.

Precautions and contraindications for pessaries will be discussed. We will dive deep into the clinical indications that suggest pessaries will be a suitable option for the patient.

Speculum use will be taught, with the focus on assessing vaginal mucosa integrity and the cervix. This training is to ensure the vaginal muscosa appears suitable for the use of pessaries. We are not covering speculum asssessments for pelvic pathologies. 

Objective measurements of prolapse will be taught using POP-Q staging, SPOP-Q staging, and Baden-Walker grading. Outcome measures for assessing symptoms and quality of life will also be discussed to ensure you know that your patients' symptoms are improving with pessary use.

You will learn practical skills on how to select the pessary based on your bio-mechanical assessment of the patients' vaginal dimensions and levator ani muscles. Fitting of the three most common pessaries used (ring, cube, and Gellhorn) will be taught and you will practice alongside Melissa in the course videos. 

On the course videos, I use advanced silicone vaginal models to teach speculum exams, POP-Q staging, levator ani muscle avulsion palpation assessments, and pessary fitting. This unique vaginal model, named 'Lily' after the Mt Cook native wild flower, is a world first in silicone models. 

Learning when and how to refer on for medical reviews when signs of complications or abnormalities will be discussed as well as when to refer onto allied health professionals.

Business and recall systems, and how to manage these within your patient management system will be discussed. Common suppliers of equipment and consumables, infection control measures, and fitting kit cleaning protocols will be provided.

Patient reports, patient medical screening request form, and patient education handouts (consent, self-management, and information on pessaries) will be reviewed and original templates will be given to you to use in your clinic.

You will also be given a copy of "The Beast", an complex Excel spreadsheet created by Simon – used for tracking all inventory related to pessary management, including supplies, fitting kit tracking, pessary tracking, and recall tracking. You'll also need to submit videos of yourself completing various practical skills.

We also offer ongoing support in a private forum for the first 12 months after the course is completed to all course participants. This is for information sharing, trouble shooting, asking clinical questions, networking, etc.

As part of the post-course requirements, we will be asking you to complete a logbook of the speculum exams completed, pessary fittings completed, a case study, a reflective statement, and a peer review. These activities will need to be completed after you complete the course over the following 6 to 12 months. We will also be asking to see a summary of your recall system, and health and safety procedures around pessary management in your clinic. Melissa will be reviewing and assessing all of these competency documents alongside your competency videos. These requirements are to ensure you reach acceptable skill and safety levels in all areas of pessary management.

Once you have completed your competency documentation successfully, your certificate of completion of the course will be issued.

In the PESSARIES Advanced course we are stepping things up to focus will be on learning how to fit and manage a wide range of other pessary types available on the market.

We will do a brief review of POP pathophysiology, looking at the bio-mechanical aspects of prolapses and how it affects our pessary selection and fitting success.

A quick review of vaginal exams, objective measures of POP, palpation of levator ani avulsions, and brief coverage of speculum examination basics will be done to ensure everyone is working at the same high level.

Each different pessary type will be reviewed with the focus on learning why to choose it and how to fit and manage it successfully.

Full demonstrations of inserting and removing each type of pessary will enable you to practice alongside Melissa in your location.  

We'll also be reviewing and critically evaluating difficult case studies involving pessaries online in a private message board on our website.