Priority 11 from the Pessary use for Prolapse PSP

UNCERTAINTY: What level of prolapse will improve with the use of a pessary? (JLA PSP Priority 11)
Overall ranking 11
JLA question ID 0054/11
Explanatory note There is a lack of clarity about whether a pessary can be used as effectively for a mild or a severe prolapse although women with a severe prolapse are less likely to be offered a trial of a pessary. 
Evidence

None identified
Health Research Classification System category Renal and urogenital
Extra information provided by this PSP
Original uncertainty examples

When can I suggest a pessary?  ~  What type and extent of pop (pelvic organ prlapse) benefits with pessary?  ~  What degree of POP is a pessary most effective for?  ~  The manufacturer’s recommendations that ring pessaries are only suitable for women with stages I and II prolapse or that Gellhorn or other space occupying pessaries should be used in women with stages III and IV prolapse.  ~  Which treatment is better for stage 2 cystocele?
Submitted by 2 x women, 3 x healthcare professionals, 2 x literature, 1 x other
PSP information
PSP unique ID 0054
PSP name Pessary use for Prolapse
Total number of uncertainties identified by this PSP. 66  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 8 September 2017