This advanced course is focused on teaching you how to conservatively manage pelvic organ prolapse, including how to assess the patient, select the pessary, and fit the appropriate pessary. The course is evidence informed but also very clinically focused, to give you the ability to step into the role of fitting pessaries with all the information and support you will need. You will have multiple practical sessions during the course to ensure you feel clinically confident at the end of the weekend.
As part of the course, pelvic organ prolapse prevalence, risk factors, and incidence will be reviewed, alongside other conservative management strategies such as lifestyle changes/modifications, pelvic floor training, and bowel and bladder health. Surgical options for pelvic organ prolapse will be discussed. Precautions and contraindications will be discussed as well as 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.
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 your patients' symptoms are improving with pessary use.
You will learn practical skills on how to select the pessary based on your 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 completed as part of your course practical's. We use multiple fitting kits on the course to ensure you can trial different sizes and shapes on the course in a safe environment. Your lying and standing assessments will be checked and we will review your POP measurement skills. You will be taking home three sample pessaries of different types to use for patient education.
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 will be reviewed and samples for you to use in your clinic will be provided. Learning when and how to refer on for medical reviews when signs of complications or abnormalities will be discussed. You will also be given access to "The Beast", an excel spreadsheet created by Simon – used for tracking all inventory related to pessary management, including supplies, fitting kit tracking, pessary tracking, and recall tracking.
As part of the post-course requirements, we will be asking you to complete a logbook of the speculum exams completed, and pessary fittings completed, a case study, a reflective statement, and a peer review. These activities will need to be completed over several months after the two-day teaching weekend. We will also be asking to see a summary of your recall system, and health and safety procedures around pessary management in your clinic. These requirements are to ensure you reach acceptable skill 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.