Table 1 Identified downsides of existing ring pessaries and possible mitigations
Identified downsides | Existing ring pessaries | Mitigation and designing of a new POP device |
|---|---|---|
Discomfort/pain during insertion, usage, and removal | Hard, durable large bodies (Diameter of 54–110 mm). Device expands at the level of the introitus, causing pain/discomfort. Partially squeezed during insertion but full-sized during removal. | A softer and pliable device when fully deployed. Insertion and removal in small dimensions within an applicator. Expansion to intended size only when already within the vagina. |
Usability cycle | A reusable only device. Needs cleaning after removal and before next insertion. Biofilms accumulate when in use for many months/years | A disposable only device. No need for handling and cleaning. No biofilms: a new device at every insertion. |
Insertion | Manual insertion only: either by a healthcare provider or by the user in the small amount of women who can self-care. | Insertion by the user herself, within a disposable applicator, at her will, regardless of place and time. |
Removal | Manual removal only in the large dimensions: either by a healthcare provider, or by the user in the small amount of women who can self-care | Removal by the user herself, by pulling a string at her will, regardless of place and time. The device collapses to small dimensions for comfortable removal. |
Length of use | Either every 3+ month by a healthcare provider, or every 1–7 days in the small amount of cases where the user is able to self-care. | Each device should be used for a limited length of time, preferably up to a week. |
Adverse events | Vaginal discharge, irritation, infection and foul smell are well described known adverse events. | A disposable only device, with short usage duration, is expected to substantially reduce or eliminate adverse events. |
Dependency on the clinic | A reusable device which is re-used for years, requires, in most cases, dependency upon clinic visits. | No dependency upon clinic visits. Device is self-inserted, Irrespective of time and place. |
Other points | Need to self-touch when able to self-care. Removal before intercourse is available only in women who can self-care. | No need of self-touch. Device comes ready for use within a disposable applicator. Easy removal before intercourse. |