Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 20;11(1):e040009.
doi: 10.1136/bmjopen-2020-040009.

"I just wear it and I become normal": a qualitative study of Tanzanian women's experiences with long-term vaginal pessary use for stress urinary incontinence

Karina Holm Nissen  1 , Benjamin C Shayo  2   3 , Vibeke Rasch  4   5 , Gileard G Masenga  2   3 , Ditte Søndergaard Linde  4   5   6
Affiliations

"I just wear it and I become normal": a qualitative study of Tanzanian women's experiences with long-term vaginal pessary use for stress urinary incontinence

Karina Holm Nissen et al. BMJ Open. .

Abstract

Introduction: Previous research has shown that vaginal pessaries are a cost-effective treatment for women worldwide suffering from stress urinary incontinence. However, little is known about African women's experiences with vaginal pessary use. The aim of this study was to understand the experiences of vaginal pessary use among Tanzanian women who had received long-term pessary treatment for stress urinary incontinence.

Methods: 15 semi-structured, individual interviews were conducted over a 2-month period in 2019 with Tanzanian women living in the Kilimanjaro Region who suffered from stress urinary incontinence and who had been using a pessary for at least 18 months. The interview transcripts were analysed using qualitative content analysis.

Results: The primary motivation for seeking treatment were discomfort from symptoms, social consequences and low quality of life. Perceived benefits from pessary use included improved quality of life with reacquired abilities to perform daily activities, participate in social gatherings, feeling symptom relief and improved sexual relations. Further, some women saw pessary treatment as superior to other locally available treatment options. Perceived barriers for pessary use included shame, husband's disapproval, limited access to treatment and lack of knowledge among the women as well as healthcare personnel.

Conclusion: Vaginal pessaries are well-perceived as a long-term treatment method among Tanzanian women suffering from stress urinary incontinence. This method may have potential to be implemented large scale in Tanzania if combined with basic health education.

Keywords: community gynaecology; gynaecology; urogynaecology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Picture of a Milex flexible incontinence ring pessary (Milex pessaries, CooperSurgical, Inc).
Figure 2
Figure 2
Flowchart and timeline of inclusion from the overall PEDITA (Pelvic floor disorders in Tanzania) study into the qualitative study.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

References

    1. Walker GJA, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J 2011;22:127–35. 10.1007/s00192-010-1215-0 - DOI - PubMed
    1. Masenga GG, Shayo BC, Msuya S, et al. . Urinary incontinence and its relation to delivery circumstances: a population-based study from rural Kilimanjaro, Tanzania. PLoS One 2019;14:e0208733. 10.1371/journal.pone.0208733 - DOI - PMC - PubMed
    1. Lipp A, Shaw C, Glavind K. Mechanical devices for urinary incontinence in women. Cochrane Database Syst Rev 2014;17:CD001756. 10.1002/14651858.CD001756.pub6 - DOI - PMC - PubMed
    1. Haylen BT, de Ridder D, Freeman RM, et al. . An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21:5–26. 10.1007/s00192-009-0976-9 - DOI - PubMed
    1. Grimby A, Milsom I, Molander U, et al. . The influence of urinary incontinence on the quality of life of elderly women. Age Ageing 1993;22:82–9. 10.1093/ageing/22.2.82 - DOI - PubMed

Publication types

LinkOut - more resources