Clinical Papers

  1. One year after treatment women with POP report similar improvement when treated with a pessary versus surgical correction. Prospective evaluation of outcome of vaginal pessaries versus surgery in women with symptomatic pelvic organ prolapse. (Z. Abdool, R. Thakar, A.H. Sultan, R.S. Oliver. Int. Urogynecol J (2011) 22:273-278)
  2. POP management with pessaries is shown to have a significant improvement in enjoyment of life and interference with physical activity. Management of pelvic organ prolapse by vaginal pessaries - one year follow up. (Oliver R, Lim J H, Thakar R, Sultan A H. Mayday University Hospital, Croydon, Surrey UK.)
  3. Pessaries have been shown to be as effective as surgery and therefore should be offered as an alternative option to surgery. Are vaginal pessaries as effective as surgery in symptomatic pelvic organ prolapse? (Z. Abdool, R. Thakar, A. Sultan. Int Urogynecol J (2006) 17 (Suppl.2))
  4. Vaginal pessaries are a cost effective way of alleviating symptoms of pelvic organ prolapse. Guidelines for the use of support pessaries in the management of pelvic organ prolapse. (University of South Australia (2010))
  5. Vaginal pessary use is a non-invasive treatment option for patients with POP who wish to postpone surgery or avoid surgical risks altogether. Pelvic Organ Prolapse - Pessary Treatment. (J.A. Shulz, E. Kwon. American Journal of Obstetrics and Gynecology 2005;193: 103-13)
  6. Pessaries provide mechanical support to the prolapsed organs, thus relieving symptoms and improving overall body image for the patient. Pessary use and impact on quality of life and body image. (Patel M.S., Mellen C, O'Sullivan D.M., Lasala C.A. Female Pelvic Medical Reconstructive Surgery (2011) Nov; 17 (6): 298-301)


Knowledge Hub Clinical References


What is Prolapse?


  1. Royal College of Obstetricians & Gynaecologists. Pelvic organ prolapse patient information leaflet. RCOG. Accessed February 8, 2023.
  2. 2Bodner-Adler B. Special Issue: Pelvic Floor Disorders: State of the Art and Future Perspectives. J Clin Med. 2022;11(21):6473. doi:10.3390/jcm11216473
  3. The American Urogynecologic Society. Pelvic Organ Prolapse. Female Pelvic Medicine & Reconstructive Surgery. 2019;25(6):397. doi:10.1097/SPV.0000000000000794
  4. Prolapse.pdf. Accessed January 25, 2023. https://www.swft.nhs.uk/application/files/1714/9486/3165/Prolapse.pdf
  5. Ghanbari Z, Ghaemi M, Shafiee A, et al. Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis. J Clin Med. 2022;11(23):7166. doi:10.3390/jcm11237166
  6. Persu C, Chapple C, Cauni V, Gutue S, Geavlete P. Pelvic Organ Prolapse Quantification System (POP–Q) – a new era in pelvic prolapse staging. J Med Life. 2011;4(1):75-81. doi:PMC3056425.
  7. Symptoms & Types - Pelvic Organ Prolapse, Voices for PFD. Accessed February 8, 2023. https://www.voicesforpfd.org/pelvic-organ-prolapse/symptoms-types/
  8. Pelvic Organ Prolapse: Symptoms and causes. Mayo Clinic. Accessed February 8, 2023. https://www.mayoclinic.org/diseases-conditions/pelvic-organ-prolapse/symptoms-causes/syc-20360557
  9. The Major Types of Pelvic Organ Prolapse and Their Differences. Advanced Gynecology. Accessed February 8, 2023. https://www.advancedgynecology.com/2020/the-major-types-of-pelvic-organ-prolapse-and-their-differences/
  10. NHS. Pelvic organ prolapse. nhs.uk. Accessed February 8, 2023. https://www.nhs.uk/conditions/pelvic-organ-prolapse/
  11. Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559-1573. doi:10.1007/s00192-015-2695-8
  12. Pelvic Organ Prolapse | Office on Women’s Health. Accessed February 8, 2023. https://www.womenshealth.gov/a-z-topics/pelvic-organ-prolapse
  13. Kuncharapu I, Majeroni BA, Johnson DW. Pelvic Organ Prolapse. AFP. 2010;81(9):1111-1117. doi:20433127.
  14. Thaker R. Pessaries for Treatment of Pelvic Organ Prolapse | GLOWM. Accessed February 8, 2023. http://www.glowm.com/section-view/heading/Pessaries for Treatment of Pelvic Organ Prolapse/item/805



What treatments are available for pelvic organ prolapse?


  1. NHS. Pelvic organ prolapse. nhs.uk. Published March 24, 2021. Accessed February 8, 2023. https://www.nhs.uk/conditions/pelvic-organ-prolapse/
  2. Royal College of Obstetricians & Gynaecologists. Pelvic organ prolapse patient information leaflet. RCOG. Accessed February 8, 2023. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/pelvic-organ-prolapse-patient-information-leaflet/
  3. Ghanbari Z, Ghaemi M, Shafiee A, et al. Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis. J Clin Med. 2022;11(23):7166. doi:10.3390/jcm11237166
  4. Pelvic Organ Prolapse. Accessed March 9, 2023. //hospital.uillinois.edu/primary-and-specialty-care/pelvic-health/men-pelvic-health-disorders/pelvic-organ-prolapse
  5. Persu C, Chapple C, Cauni V, Gutue S, Geavlete P. Pelvic Organ Prolapse Quantification System (POP–Q) – a new era in pelvic prolapse staging. J Med Life. 2011;4(1):75-81. doi:PMC3056425.
  6. Mulkeen N. NHS Physiotherapy Department Prolapse. Published online January 2015. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.swft.nhs.uk/application/files/1714/9486/3165/Prolapse.pdf
  7. Pelvic organ prolapse symptoms and treatments. Accessed March 9, 2023. https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse
  8. Pelvic organ prolapse - Treatment. nhs.uk. Published October 20, 2017. Accessed February 15, 2023. https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/
  9. Bodner-Adler B. Special Issue: “Pelvic Floor Disorders: State of the Art and Future Perspectives.” J Clin Med. 2022;11(21):6473. doi:10.3390/jcm11216473
  10. Pessaries for Prolapse. Accessed February 21, 2023. https://thepogp.co.uk/patient_information/womens_health/pessaries_for_prolapse.aspx
  11. How your weight impacts your pelvic floor. Continence Foundation of Australia. Accessed February 21, 2023. https://www.continence.org.au/news/how-your-weight-impacts-your-pelvic-floor
  12. Pelvic Obstetric and GP. The Pelvic Floor Muscles - a Guide for Women. Published online 2015. https://www.iow.nhs.uk/Downloads/Pelvic%20Floor%20Physiotherapy/Pelvic%20Floor%20Exercise%20for%20womez.pdf
  13. The Impact of Smoking on Your Pelvic Health   Kegel8. Accessed February 21, 2023. https://www.kegel8.co.uk/blog/smoking-pelvic-health
  14. What are pelvic floor exercises? nhs.uk. Published June 27, 2018. Accessed March 9, 2023. https://www.nhs.uk/common-health-questions/womens-health/what-are-pelvic-floor-exercises/
  15. Physiotherapist AMKPF. When to Relax Pelvic Floor Muscles (to Avoid Pelvic Pain) - Pelvic Exercises. Published November 20, 2018. Accessed February 20, 2023. https://www.pelvicexercises.com.au/when-to-relax-pelvic-floor/
  16. Charity -Menopause. Vaginal Dryness. The Menopause Charity. Published October 21, 2021. Accessed March 9, 2023. https://www.themenopausecharity.org/2021/10/21/vaginal-dryness-2/
  17. Instances When a Pessary May Not Work – Toronto Pessary Clinic. Published September 2, 2019. Accessed March 9, 2023. https://torontopessaryclinic.com/instances-when-a-pessary-may-not-work/
  18. Thaker R. Pessaries for Treatment of Pelvic Organ Prolapse   GLOWM. Published July 2014. Accessed February 8, 2023. http://www.glowm.com/section-view/heading/Pessaries for Treatment of Pelvic Organ Prolapse/item/805
  19. Mesh for vaginal wall prolapse should only be used in the context of research, says NICE   News   News. NICE. Published December 15, 2017. Accessed March 9, 2023. https://www.nice.org.uk/news/article/mesh-for-vaginal-wall-prolapse-should-only-be-used-in-the-context-of-research-says-nice
  20. Pelvic organ prolapse - Care at Mayo Clinic - Mayo Clinic. Accessed February 15, 2023. https://www.mayoclinic.org/diseases-conditions/pelvic-organ-prolapse/care-at-mayo-clinic/mac-20360560
  21. Life after pelvic organ prolapse surgery: a guide to recovery   Nuffield Health. Accessed February 21, 2023. https://www.nuffieldhealth.com/article/life-after-pelvic-organ-prolapse-surgery-recovery


The long history of Pessaries


  1. NHS. Pelvic organ prolapse. nhs.uk. Published March 24, 2021. Accessed February 8, 2023. https://www.nhs.uk/conditions/pelvic-organ-prolapse/
  2. Oliver R, Thakar R, Sultan AH. The history and usage of the vaginal pessary: a review. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2011;156(2):125-130. doi:10.1016/j.ejogrb.2010.12.039
  3. Pelvic organ prolapse - Treatment. nhs.uk. Published October 20, 2017. Accessed February 15, 2023. https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/
  4. Shah SM, Sultan AH, Thakar R. The history and evolution of pessaries for pelvic organ prolapse. Int Urogynecol J. 2006;17(2):170-175. doi:10.1007/s00192-005-1313-6
  5. Royal College of Obstetricians & Gynaecologists. Pelvic organ prolapse patient information leaflet. RCOG. Accessed February 8, 2023. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/pelvic-organ-prolapse-patient-information-leaflet/
  6. Contemporary Use of the Pessary  GLOWM. Accessed March 24, 2023. http://www.glowm.com/section-view/heading/Contemporary Use of the Pessary/item/25
  7. Charles Goodyear.  American inventor.  Britannica. Accessed March 24, 2023.  https://www.britannica.com/biography/Charles-Goodyear
  8. Dwyer L, Dowding D, Kearney R. What is known from the existing literature about self- management of pessaries for pelvic organ prolapse? A scoping review. Published online 2015.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297214/pdf/bmjopen-2021-060223.pdf
  9. Pessaries for Treatment of Pelvic Organ Prolapse  GLOWM. Accessed March 24, 2023. http://www.glowm.com/section-view/heading/Pessaries for Treatment of Pelvic Organ Prolapse/item/805
  10. Mao M, Ai F, Zhang Y, et al. Changes in the symptoms and quality of life of women with symptomatic pelvic organ prolapse fitted with a ring with support pessary. Maturitas. 2018;117:51-56. doi:10.1016/j.maturitas.2018.09.003
  11. Baessler K, O’Neill S, Battistutta D. Guidelines for the Use of Support Pessaries in the Management of Pelvic Organ Prolapse. Published online 2010. https://continencematters.com/assets/files/Pessary_Guidelines.pdf
  12. Morris C, Munro C, Navani M. Female genital prolapse. InnovAiT. 2022;15(7):394-401. doi:10.1177/17557380221094342
  13. Zeiger BB, da Silva Carramão S, Del Roy CA, da Silva TT, Hwang SM, Auge APF. Vaginal pessary in advanced pelvic organ prolapse: impact on quality of life. Int Urogynecol J. 2022;33(7):2013-2020. doi:10.1007/s00192-021-05002-7
  14. Abdulaziz M, Stothers L, Lazare D, Macnab A. An integrative review and severity classification of complications related to pessary use in the treatment of female pelvic organ prolapse. Can Urol Assoc J. 2015;9(5-6):E400-E406. doi:10.5489/cuaj.2783
  15. Commonly used pessary types – a practical guide. https://thepogp.co.uk/_userfiles/pages/files/pessary_types_guide.pdf