CClinicalTrials.gg
Status unknownNCT01644214EPICUpdated Dec 4, 2019

Extended Pessary Interval for Care (EPIC Study)

An interventional study of 6 month follow up for pessary check in the clinic setting in Pelvic Organ Prolapse and Pessary, sponsored by Unity Health Toronto. Status unknown at 1 site in Canada. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-12-04.

Sponsored by Unity Health Toronto · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Dec 2019), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
13
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

Objectives: Pelvic organ prolapse (POP) is a common condition for which pessaries are commonly used in conservative treatment. Despite their prevalence, there is no literature to guide the management of pessaries. Our objective is to determine whether patients managed with a pessary for POP are more satisfied with follow-up at 3 or 6 month intervals and if there is any difference in complications rates between the two groups.

Hypothesis: The investigators hypothesize that there will be higher patient satisfaction in the group randomized to 6 month follow-up intervals and that there will be no difference in complication rates between the two follow-up groups.

Method: The investigators will conduct a prospective randomized control trial comparing patient satisfaction and complication rates between patients with pessaries randomized to either 3 or 6 month follow-up intervals over 1 year.

02

Conditions studied

  • Pelvic Organ Prolapse
  • Pessary

Keywords

  • Pelvic organ prolapse
  • Pessary
03

In context

Prolapse

676 studies on the registry are indexed under Prolapse; 79 are open to participants now.

This study's enrollment of 13 is below the median of 74 across 435 interventional studies indexed under Prolapse.

Browse Prolapse studies →

Lead sponsor

Unity Health Toronto is the lead sponsor of 434 studies on the registry; 76 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 1 (20%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Females with POP who have opted for conservative management with a pessary
  • Able to read and write English
  • First time pessary users
  • Successful fitting with a covered ring or Gellhorn pessary, as determined at the usual early follow-up visit 2-4 weeks after initial fitting (successful defined as: no expulsion on movement, squatting or valsalva, no urinary retention, no discomfort, and still retained pessary after 2 weeks)
  • Patients agree to use vaginal estrogen (either tablet or cream twice weekly) during the study period; patients may not use a vaginal estrogen ring since this requires changing every 3 months, and will interfere with the study follow-up schedule

Exclusion criteria

Exclusion criteria:

  • Current presence of vaginal bleeding, vaginal abrasions or ulcers, or vaginal infection
  • Significant cognitive impairment
  • Pessary used for indication other than POP (ie. urinary incontinence)
  • Use of a pessary that is not a covered ring or Gellhorn (i.e exclude cube, donut, etc.)
  • Contraindications to vaginal estrogen
  • Unsuccessful pessary fitting (successful defined as: no expulsion on movement, squatting or valsalva, no urinary retention, no discomfort, and still retained pessary after 2 weeks)
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
13 participants (actual)

Study arms

  • No intervention
    Pessary Check at 3 months

    Patients seen at 3 month intervals for pessary check-ups is the most common interval check in our clinic so this arm is considered the control group.

  • Experimental
    6 month Pessary Check

    Those that will be seen at 6 month follow-up visits for pessary maintenance will be considered the experimental group of the study.

    Other: 6 month follow up for pessary check in the clinic setting

Interventions

  • Other6 month follow up for pessary check in the clinic setting

    The standard of care is considered to be pessary checks every 3 months, therefore those that are checked every 6 months will be considered to be in the intervention group.

06

What researchers measure

Primary outcomes

  1. Patient satisfaction

    To determine if patients managed with a pessary for POP are more satisfied with follow-up at 6 or 12 weeks over a one year period.

    Time frame: At 6 months from study enrollment

  2. Patient satisfaction

    To determine if patients managed with a pessary for POP are more satisfied with follow-up at 6 or 12 weeks over a one year period.

    Time frame: At 12 months from study enrollment

Secondary outcomes

  1. Pessary associated complications

    To determine if there is a difference in complication rates associated with indwelling pessaries between those that are seen at 6 week intervals and those that are seen at 12 week intervals, over a one year time period.

    Time frame: Checked at all follow-up visits (3 and 6 months, depending on study group)

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Study locations

1 site
  • Women's College Hospital/Mount Sinai Hospital
    Toronto, Ontario M5G 1Z5, Canada
08

References and documents

Publications

  • Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999 Feb;180(2 Pt 1):299-305. doi: 10.1016/s0002-9378(99)70203-6. PubMed 9988790 ↗
  • MacLennan AH, Taylor AW, Wilson DH, Wilson D. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG. 2000 Dec;107(12):1460-70. doi: 10.1111/j.1471-0528.2000.tb11669.x. PubMed 11192101 ↗
  • Fernando RJ, Thakar R, Sultan AH, Shah SM, Jones PW. Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse. Obstet Gynecol. 2006 Jul;108(1):93-9. doi: 10.1097/01.AOG.0000222903.38684.cc. PubMed 16816061 ↗
  • Schaffer JI, Wai CY, Boreham MK. Etiology of pelvic organ prolapse. Clin Obstet Gynecol. 2005 Sep;48(3):639-47. doi: 10.1097/01.grf.0000170428.45819.4e. No abstract available. PubMed 16012231 ↗
  • Atnip SD. Pessary use and management for pelvic organ prolapse. Obstet Gynecol Clin North Am. 2009 Sep;36(3):541-63. doi: 10.1016/j.ogc.2009.08.010. PubMed 19932415 ↗
  • Pott-Grinstein E, Newcomer JR. Gynecologists' patterns of prescribing pessaries. J Reprod Med. 2001 Mar;46(3):205-8. PubMed 11304859 ↗
  • Thakar R, Stanton S. Management of genital prolapse. BMJ. 2002 May 25;324(7348):1258-62. doi: 10.1136/bmj.324.7348.1258. No abstract available. PubMed 12028982 ↗
  • Sarma S, Ying T, Moore KH. Long-term vaginal ring pessary use: discontinuation rates and adverse events. BJOG. 2009 Dec;116(13):1715-21. doi: 10.1111/j.1471-0528.2009.02380.x. PubMed 19906018 ↗
  • Powers K, Grigorescu B, Lazarou G, Greston WM, Weber T. Neglected pessary causing a rectovaginal fistula: a case report. J Reprod Med. 2008 Mar;53(3):235-7. PubMed 18441734 ↗
  • Ko PC, Lo TS, Tseng LH, Lin YH, Liang CC, Lee SJ. Use of a pessary in treatment of pelvic organ prolapse: quality of life, compliance, and failure at 1-year follow-up. J Minim Invasive Gynecol. 2011 Jan-Feb;18(1):68-74. doi: 10.1016/j.jmig.2010.09.006. PubMed 21195956 ↗
  • Lamers BH, Broekman BM, Milani AL. Pessary treatment for pelvic organ prolapse and health-related quality of life: a review. Int Urogynecol J. 2011 Jun;22(6):637-44. doi: 10.1007/s00192-011-1390-7. Epub 2011 Apr 7. PubMed 21472447 ↗
  • Wu V, Farrell SA, Baskett TF, Flowerdew G. A simplified protocol for pessary management. Obstet Gynecol. 1997 Dec;90(6):990-4. doi: 10.1016/s0029-7844(97)00481-x. PubMed 9397117 ↗
  • Gorti M, Hudelist G, Simons A. Evaluation of vaginal pessary management: a UK-based survey. J Obstet Gynaecol. 2009 Feb;29(2):129-31. doi: 10.1080/01443610902719813. PubMed 19274547 ↗
  • Adams E, Thomson A, Maher C, Hagen S. Mechanical devices for pelvic organ prolapse in women. Cochrane Database Syst Rev. 2004;(2):CD004010. doi: 10.1002/14651858.CD004010.pub2. PubMed 15106231 ↗
  • Crandall C. Vaginal estrogen preparations: a review of safety and efficacy for vaginal atrophy. J Womens Health (Larchmt). 2002 Dec;11(10):857-77. doi: 10.1089/154099902762203704. PubMed 12626086 ↗
  • Bugge C, Adams EJ, Gopinath D, Stewart F, Dembinsky M, Sobiesuo P, Kearney R. Pessaries (mechanical devices) for managing pelvic organ prolapse in women. Cochrane Database Syst Rev. 2020 Nov 18;11(11):CD004010. doi: 10.1002/14651858.CD004010.pub4. PubMed 33207004 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 4, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01644214
Lead sponsor
Unity Health Toronto
Collaborators
Women's College Hospital, Mount Sinai Hospital, Canada
Responsible party
Sponsor
First posted
Jul 19, 2012
Start date
Nov 2016
Primary completion
Nov 2019
Completion
Mar 2020 (estimated)
Last update
Dec 4, 2019

Study contacts

Colleen D McDermott, MD, FRCSC
principal investigator · St. Michael's Hospital, Women's College Hospital, University of Toronto

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Dec 2019. You cannot join it, but the record below documents what was studied.

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