Choosing Wisely:

Don’t exclude pessaries as a treatment option for pelvic organ prolapse.

Rationale and Comments: Nonsurgical treatment options for pelvic organ prolapse include pessaries, which are removable devices that are placed into the vagina to support the prolapsed organs (i.e., uterus, vagina, bladder and/or rectum). A pessary trial can be offered to almost all women with pelvic organ prolapse. Exceptions include women with an active vaginal infection and those who would be noncompliant with follow-up.
Sponsoring Organizations:
  • American Urogynecologic Society
  • Sources:
  • Cochrane Database of Systematic Reviews
  • Disciplines:
  • Gynecologic
  • References: • Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstet Gynecol. 2012 Apr;119(4):852-60.
    • ACOG Practice Bulletin No. 85: Pelvic organ prolapse. Obstet Gynecol. 2007 Sep;110(3):717-29.
    B• ugge C, Adams EJ, Gopinath D, Reid F. Pessaries (mechanical devices) for pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013 Feb 28;2:CD004010.

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