Timely guideline for pessary practice is published

The CSP has helped fund the first ever UK guideline on best practice in the use of pessaries for pelvic organ prolapse (POP) - a condition where the uterus or wall of the vagina around the bowel or bladder bulges downwards towards the entrance of the vagina.  

POP can cause a myriad of issues, including bowel or bladder problems and pain during sexual intercourse.  

UK Clinical Guideline, the title of the evidence-based newly published document, is for healthcare professionals and women seeking information about pessary use for prolapse. 

Facts on pelvic organ prolapse (POP)

  • POP or vaginal prolapse is detectable in about 50 per cent of all women 
  • about 30 per cent are symptomatic and require treatment 
  • the reoperation rate for surgery for prolapse is considered unacceptably high with quoted rates of 30 per cent
  • the current pause on surgery for prolapse, using a synthetic mesh, has reduced the number of operations being performed 

The guideline features the first nationally available standards and training framework to direct practitioner training. 

It has downloadable sections for physiotherapists and other health professionals, including a clinical standards logbook. There are also downloadable sections for patients seeking information, such as the self-management of pessaries. 

The UK Clinical Guideline has been developed by a multidisciplinary team of members from various stakeholder groups including: pessary users; the United Kingdom Continence Society (UKCS); the Royal College of Nursing; and the CSP's Pelvic Obstetric and Gynaecological Physiotherapy (POGP) professional network.

POGP applied for funding of £8,000 from the CSP, following a recognition of the need for the guideline. The funding was used to meet a variety of expenses, including the cost of producing a patient leaflet and a multi professional survey. The UKCS also provided a £5,000 research grant, which covered the cost of service evaluation to determine where and who delivers pessary care in the UK. The funding also covered the cost of travel expenses for meetings with relevant stakeholders.

Kate Lough, chair of the guideline group and chair of POGP, said: 'The guide is timely, because of an increased use of pessaries as part of the non-surgical management of prolapse, now that there is a pause on surgery for prolapse using a synthetic mesh. This pause has remained in place since Baroness Cumberlege’s First Do No Harm report in July 2020.' 

The UK Clinical Guideline does not include Covid-19 relevant guidance. Physiotherapists and other healthcare professionals involved with pessary provision are advised to access the Covid-19 guidance document available on the website of BSUG .

The guideline is not a substitute for advice and training from an appropriate healthcare professional. 


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