Women’s heath researchers awarded funding to boost treatment for pelvic organ prolapse

Health researchers at Glasgow Caledonian University are to investigate the effectiveness of pelvic floor exercises and vaginal pessaries together in treating women with pelvic organ prolapse.

Professors Suzanne Hagen, Carol Bugge and Helen Mason, and Dr Melanie Dembinsky were awarded £1.7 million funding from the National Institute for Health and Care Research (NIHR) to carry out the research project.

Professors Hagen and Bugge (pictured) have also been busy this week sharing their expertise and research with health professionals around the world at the International Continence Society (ICS) Conference in Madrid.

Professor Hagen gave a ‘State of the Art Lecture on Primary Prevention and Conservative Treatment of Organ Prolapse’, while Professor Bugge gave two talks on recent research findings which have helped to significantly improve the lives of women with prolapse.

Their latest NIHR-funded project is entitled ‘Health Technology Assessment (HTA) - Randomised controlled trial of the clinical and cost effectiveness of supervised pelvic floor muscle training plus vaginal pessary compared to supervised pelvic floor muscle training alone for management of pelvic organ prolapse’.

The aim of this research is to find out if wearing a vaginal pessary while exercising pelvic floor muscles is better at improving symptoms than exercising pelvic floor muscles without a pessary, for women with prolapse.

Pelvic organ prolapse is when the organs in a women’s pelvis descend into her vagina. Prolapse is very common, affecting 40% of women over the age of 50, and becomes more common as women age. It has distressing symptoms and negative effects on women’s daily Lives.

One common treatment is pelvic floor muscle training (PFMT) where women are taught by a specialist physiotherapist or nurse how to exercise the muscles around their vagina. If this is done regularly, over time it can reduce the symptoms of prolapse.

A vaginal pessary is another treatment for prolapse. The pessary, which is a plastic or silicone device often shaped like a ring, is inserted into the woman’s vagina to lift and hold the pelvic organs in place.

UK guidelines recommend that women with prolapse consider PFMT treatment and, separately, they can consider pessary treatment. The guidelines suggest that research is needed to find out if adding a pessary to PFMT would be more effective than PFMT alone.

Through previous pelvic organ prolapse research, some UK physiotherapists have told the team at Glasgow Caledonian that they combine the two treatments in their practice, and they think using a pessary can be beneficial as it holds up the prolapse during PFMT, improving symptoms even more.

They also said that only one study in a single hospital in Hong Kong has looked at the combined treatment but it had some limitations, sparking the need for a larger study with stronger methods.

In this new study, the researchers will invite women with prolapse who are starting PFMT treatment to take part. Some will receive PFMT alone, while others will receive the combined treatment, and their symptoms will be monitored over a 12-month period.

The findings of the study will be shared with those who took part in the research, with groups who support women with prolapse, and with healthcare staff and people who plan health services.

Professor Hagen is a Professor of Health Services Research and Professor Bugge is a Professor of Nursing, in the University's School of Health and Life Sciences (SHLS). Professor Hagen is also co-lead of the SHLS Research Centre for Health (ReaCH) Ageing Well Research Group, and Professor Bugge is a member of the group.