Priority 16 from the Pessary use for Prolapse PSP

UNCERTAINTY: What differences does a pessary make when used to treat a prolapse? (JLA PSP Priority 16)
Overall ranking	16
JLA question ID	0054/16
Explanatory note	Future research needs to provide information about how a pessary works as a treatment for symptomatic prolapse. Examples: When a pessary is inserted, does pelvic floor function improve? Can a pessary help with pain asscoiated with POP?
Evidence	None identified
Health Research Classification System category	Renal and urogenital

Extra information provided by this PSP
Original uncertainty examples	Are pessaries helpful for those women suffering with grade 1 prolapse to to simply help them feel supported / less heavy? ~ Do pessaries completely put the prolapse back into place ? ~ Are removable pessary devises like the cube any worse for symptom relief than ring pessaries designed for longer use in situ? ~ When a pessary is inserted, does pelvic floor function improve? ~ Pessaries are the best choice for immediate relief of urinary stress incontinence and for reducing a prolapse. ~ Can a pessary help with pain asscoiated with POP? ~ Do pessaries halt prolapse worsening /deterioration? ~ Can the use of pessaries exacerbate some prolapse, i.e. a ring pessary can make a rectocele worse, or even led to a rectocele? ~ Do pessaries help to prevent prolapse worsening in young active women?
Submitted by	14 x women, 5 x both, 2 x other, 7 x healthcare professionals, 4 x literature

Extra information provided by this PSP

Original uncertainty examples

Are pessaries helpful for those women suffering with grade 1 prolapse to to simply help them feel supported / less heavy? ~ Do pessaries completely put the prolapse back into place ? ~ Are removable pessary devises like the cube any worse for symptom relief than ring pessaries designed for longer use in situ? ~ When a pessary is inserted, does pelvic floor function improve? ~ Pessaries are the best choice for immediate relief of urinary stress incontinence and for reducing a prolapse. ~ Can a pessary help with pain asscoiated with POP? ~ Do pessaries halt prolapse worsening /deterioration? ~ Can the use of pessaries exacerbate some prolapse, i.e. a ring pessary can make a rectocele worse, or even led to a rectocele? ~ Do pessaries help to prevent prolapse worsening in young active women?

Submitted by

14 x women, 5 x both, 2 x other, 7 x healthcare professionals, 4 x literature

PSP information
PSP unique ID	0054
PSP name	Pessary use for Prolapse
Total number of uncertainties identified by this PSP.	66 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	8 September 2017