Does self-management of vaginal pessaries improve care for women with pelvic organ prolapse?

### What you need to know Pelvic organ prolapse is common in women over the age of 50 and negatively affects their quality life.1 Management includes lifestyle modification, pelvic floor muscle training, vaginal pessary, or surgery.2 Pessaries may be preferred by as an alternative surgery while they await surgery. In observational study UK (680 women), two thirds initially conservative management with pessaries. Women were more likely consider if bothered severe symptoms affecting bowel emptying, sexual function, life.3 A pessary inserted into vagina hold up walls organs relieve (figure 1 shows types pessary). Two are commonly used: support pessaries—such rings—and space occupying Gellhorn shelf can general practitioners, specialist nurses, physiotherapists, gynaecologists. Guidance from National Institute for Health Care Excellence (NICE) recommends removing replacing at least every six months prevent detect complications such ulceration.2 NICE guidance does not …