A study into pessaries for prolapse could change practice in the UK and beyond, according to one of the authors.

The TOPSY study is the first trial of self-managing prolapse pessaries. And the results are encouraging.

Wael Agur, one of the study authors, said: “To avoid surgery, a number of gynaecologists already routinely offer women who can self-manage the option to do so. Our study is confirming this has better safety with comparable success to clinic-based pessary care. If nationally adopted, self management of pessaries for prolapse would decrease unpleasant complications for women and reduce service costs.”

Prolapse is a common condition in women where the pelvic organs (bladder, bowel or womb) descend into the vagina causing distressing symptoms that affect quality of life. Two thirds of women initially choose a vaginal support pessary to treat their prolapse symptoms. It is usually fitted at a gynaecological clinic and the woman returns every 6 months to have it removed and changed.

However, it is possible that women could remove, clean and reinsert their pessary themselves at home (self-management), offering them more confidence in their ability to maintain and improve their own health.

• Pessaries are an alternative to surgery, both native tissue and mesh. The paper says “Prolapse can be treated conservatively or surgically. Up to 18.5% of women who have prolapse surgery may need a further prolapse repair procedure and the recent controversy around the use of surgical mesh has resulted in a focus on conservative treatment options.“

• The TOPSY study has been published in this month’s Lancet.

• The main trial centres are in Norwich, Newcastle, Taunton, Manchester, Scotland, London and Cambridge. Urogynaecologist Ranee Thakar, current RCOG President, is a co-author. She recruited patients in Croydon, London, to the study.