Women’s Health


Pessary Use in Primary Care: A Simulation-Based Workshop

Friday, November 24
10:45 AM - 11:45 AM

Pelvic organ prolapse (POP) affects up to 50% of parous women causing significant morbidity such as stress urinary incontinence (SUI). SOGC recommends pessaries as first line management for symptomatic patients. The wait time to see a urogynecologist is increasing.
Pessary fitting and care is within the scope of practice of family physicians though training opportunities are limited, in part due to few family physician teachers. Family physicians should be encouraged to acquire pessary fitting and pessary care follow up skills for patients who are candidates for conservative management reserving referral to urogynecologist for more complex cases of POP and SUI.
This interactive workshop starts by reviewing patients with POP and SUI who are appropriate for non-surgical management. We discuss patient and pelvic factors impacting patient selection and patient exclusion. We then present common pessaries for use in primary care and discuss risk versus benefit. Patient education, follow up, identification of common complications as well as prevention and management of complications are taught. Physicians then practice three simulation scenarios with 3D pelvic models and pessaries: 1) pre menopausal woman with SUI and no POP; 2) post menopausal woman with moderate POP and SUI; and 3) post menopausal woman with severe POP. Each scenario allows learners to practice the process of patient and pessary selection, fit and practice the removal and reinsertion of pessaries, and review follow up and management of complications.

Learning Objectives:

Parisa Rezaiefar

Family Physician, CFPC, Assistant Professor
University of Ottawa, Department of Family Medicine

Dr. Parisa Rezaiefar is a family physician and assistant professor at the Department of Family Medicine, University of Ottawa. She leads a weekly women’s health clinic at Bruyère Academic Family Health Team focusing on teaching family medicine residents about women’s health procedural skills using simulation. She is the recipient of the 2013 CFPC grant in women’s health to develop further skills in women’s health with a focus on conservative management of pelvic organ prolapse. She is also the recipient of a 2015 Department of Family Medicine Research Grant and Program for Innovation in Medical Education to examine the use of simulation-based education in building capacity among academic family physicians and family medicine residents at Bruyère Academic Family Health Team in conservative management of pelvic organ prolapse.


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Kelly Forse

Family Physician, CFPC, Candidate for Women's Health fellowship graduation July 2016
University of Ottawa, Department of Family Medicine

Dr. Kelly Forse is currently completing third year studies in the Women’s Health program at the University of Ottawa. She completed her residency in family medicine at North York General Hospital, University of Toronto after finishing medical school at St. George’s University. She has a Master’s degree in Public Administration from Queen’s University and completed an Honours degree in Human Biology at the University of Toronto.


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