Priority 9 from the Pessary use for Prolapse PSP
|UNCERTAINTY: When should oestrogen cream be used with a pessary? (JLA PSP Priority 9)
|JLA question ID
|There is a wide variation in practice across the world in relation to the use of oestrogen cream with pessaries either as routine or only when indicated by the vaginal condition. This priority could be added to future trials involving pessary use for prolapse. Examples: Does use of oestrogen creams with pessaries increases satisfaction and persistence, or decreases adverse events? Do topical estrogen improve the vaginal sensation when using pessaries? Should an oestrogen cream be used as routine, or only with atrophic changes?
|Health Research Classification System category
|Renal and urogenital
|Extra information provided by this PSP
|Original uncertainty examples
The use of topical vaginal oestrogen (in the absence of any contraindications) in postmenopausal women and women with vaginal atrophy may be helpful in reducing pessary complications and is commonly prescribed, however, high level evidence for its use is lacking. ~
|12 x healthcare professionals, 4 x literature, 1 x both
|PSP unique ID
|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