Global Engagement with an Educational Video on Vaginal Pessaries: A 9-Year Mixed-Methods Analysis of YouTube Analytics and User Comments.

INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) remains underdiagnosed and undertreated worldwide, and pessaries are an effective yet underutilized conservative option. Digital platforms may play a key role in disseminating evidence-based guidance. This study analyzed long-term global engagement with an educational video on vaginal pessaries to understand patterns of access, audience characteristics, and informational needs. METHODS: A mixed-methods design was used. Quantitative data were extracted from YouTube Analytics over a 9-year period (2017-2026), including views, watch time, audience demographics, traffic sources, devices, and geographic distribution. Qualitative content analysis was conducted on 107 valid user comments (43.1% of all registered comments) to identify informational demands, emotional responses, and perceived gaps in clinical counseling. RESULTS: The video accumulated 69,802 views and 3652.7 h of watch time, with a mean audience retention of 32.54%. Viewers represented more than 40 countries, with notable engagement from East Asia. Adults aged 25-34, 45-54, and 55-64 years accounted for most views. Mobile devices accounted for over 80% of views; televisions showed the highest retention. Comments revealed unmet informational needs, prior suffering, and strong interest in practical pessary guidance. CONCLUSIONS: This long-term analysis shows that this educational video on pessary use expanded access to information and addressed expressed gaps in clinical counseling, supporting viewers' engagement with POP conservative treatment options. Validated digital content may represent a scalable, durable complement to urogynecologic education.