£1.1m pessary trial could provide physiotherapists with new treatment options

A £1.1 million trial will assess whether a self-management programme could offer physiotherapists new treatment options to improve the lives of women with pelvic organ prolapse.


The trial could lead to physiotherapists offering new treatment options for pelvic organ prolapse

The condition, affecting about 40 per cent of women over 40, occurs when the bladder, bowel or womb descend into the vagina, causing distressing symptoms.

Many women initially choose to be fitted with a pessary inserted into the vagina to support the pelvic organs. The procedure is usually carried out at a gynaecology clinic or GP surgery. Patients return approximately every six months to have the pessary replaced.

The trial, involving 330 women, will examine whether women could remove and reinsert their pessary themselves at home. This could offer them more control over maintaining and improving their own health.

It will also explore whether self-management is more, or less, expensive than standard practice.

The trial involves the nursing, midwifery and allied health professions research unit at Glasgow Caledonian University and St Mary’s Hospital, part of Manchester University NHS Trust. It will be completed in 2021.

Claire Brown, who leads the women’s and men’s physiotherapy team at Addenbrooke’s Hospital, Cambridge, said: ‘If this trial is a success, it will give physiotherapists scope for offering more treatment options to women – in addition to pelvic floor exercises, lifestyle adjustment and conservative management – as an alternative to surgery.’

‘We know that the readmission rate after surgery to correct prolapse is 13-30%. If you can prevent women having surgery in the first place, you will be saving the NHS a lot of money.’

In 2013 Ms Brown was part of team of St Mary’s which carried out self-management trials in which women were taught how to insert pessaries.

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