Glasgow Caledonian University researchers say thousands of women could benefit from their new collaborative research which shows the success of a pessary in helping to self-manage pelvic organ prolapse.

This new research led by the university’s Research Centre for Health (ReaCH) shows the low-cost treatment can lead to fewer complications for women living with pelvic organ prolapse – a condition where one or more pelvic organs move from their normal position and place pressure onto the vaginal wall.

While this condition is common, affecting 40% of women over 50 in the UK, it can cause discomfort and pain.

A prosthetic device called a pessary can be provided to women with this condition to help hold their bladder, bowel or womb in place.

Most women who use a pessary need to attend clinics for their care, returning every six months for check-ups. However, the findings of this six-year £1.1m study have identified the benefits of pessary self-management.

Lead researchers Professor Carol Bugge and Professor Suzanne Hagen say this could ‘change the lives’ of thousands of women.

Professor Bugge said the Treatment of Prolapse with Self-Care Pessary (TOPSY) study of 340 women shows that women can safely self-manage their pessary from home:

“No matter their age, they may experience fewer complications and there will be less cost to the NHS in the long-run by freeing up appointments.

“Pessaries are a very commonly used treatment in the NHS and the mainstay of treatment is that women have to return to clinics roughly every six months, which can be inconvenient and costly.

“Our belief is that by giving the control of their health back to the women it would make their quality of life better.

“We are reaching out to women and healthcare professionals who provide pessary care with these results, so they can see that self-management is a valid option for them. It offers safety, it doesn’t worsen their quality-of-life, there are fewer complications and for services, it costs less and it frees appointments.”

Professor Bugge, who first began this study while working at the University of Stirling, added that the research team have created materials to help train health professionals in supporting self-management.

Margaret Graham, 63, from Ayrshire, has been using a pessary for the past 10 years and was a patient representative in the study. She said she was “impressed and amazed” at the rigour and care taken in the research:

“It’s so important that women are presented and supported with as many options as possible for what can be nearly another half of their lives.

“I was really delighted when I was presented with the option of a pessary for this condition. I was gobsmacked that this simple silicone donut-shaped thing worked. I thought the only option was surgery and it was terrifying.

“The results of this study could really change thousands of women’s lives if a self-management programme was rolled out because it’s safer, has less complications and stops the need to attend clinics as often.”

The team says they hope self-management can be rolled out more widely across the UK but more research is needed into how it can be made routine practice. Professor Bugge explained:

“Practitioners need to have the skills to teach patients how to self-manage and that’s why we need more research to look into how best to make this happen on a larger scale.”

Professor Hagen said that this unique, “first in its field” trial has provided a robust foundation for longer-term work, adding:

“We have really made an excellent contribution to the evidence for prolapse management. It was a fully-powered trial with enough participants involved to give us robust answers. It was also diverse in terms of the age ranges of the women involved and their geographical location within the UK.”

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