Priority 11 from the Pessary use for Prolapse PSP

UNCERTAINTY: What level of prolapse will improve with the use of a pessary? (JLA PSP Priority 11)
Overall ranking	11
JLA question ID	0054/11
Explanatory note	There is a lack of clarity about whether a pessary can be used as effectively for a mild or a severe prolapse although women with a severe prolapse are less likely to be offered a trial of a pessary.
Evidence	None identified
Health Research Classification System category	Renal and urogenital

Extra information provided by this PSP
Original uncertainty examples	When can I suggest a pessary? ~ What type and extent of pop (pelvic organ prlapse) benefits with pessary? ~ What degree of POP is a pessary most effective for? ~ The manufacturer’s recommendations that ring pessaries are only suitable for women with stages I and II prolapse or that Gellhorn or other space occupying pessaries should be used in women with stages III and IV prolapse. ~ Which treatment is better for stage 2 cystocele?
Submitted by	2 x women, 3 x healthcare professionals, 2 x literature, 1 x other

Extra information provided by this PSP

Original uncertainty examples

When can I suggest a pessary? ~ What type and extent of pop (pelvic organ prlapse) benefits with pessary? ~ What degree of POP is a pessary most effective for? ~ The manufacturer’s recommendations that ring pessaries are only suitable for women with stages I and II prolapse or that Gellhorn or other space occupying pessaries should be used in women with stages III and IV prolapse. ~ Which treatment is better for stage 2 cystocele?

Submitted by

2 x women, 3 x healthcare professionals, 2 x literature, 1 x other

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