Chapter 3 - Conservative Treatment of the Patient with Pelvic Organ Prolapse

The committees in this chapter will focus on conservative management of Pelvic Organ Prolapse (POP). This will include topics on pessary management, physical therapy (PFMT, biofeedback), and weight loss/lifestyle modifications/mind body therapy (central desensitization).

The paper on Pelvic Floor Muscle Training (Physiotherapy, Biofeedback) has published in the IUJ online.  Click the chapter heading below to view the article.


1. Pessary Management
This committee will review the published literature regarding the use of pessaries for the treatment of pelvic organ prolapse (not stress urinary incontinence or other pelvic floor disorders). The review will encompass:

  • patient populations to whom pessaries are offered
  • benefits and complications / risks in the short and long-term
  • data regarding pessary choices and factors guiding those choices
  • maintenance patterns (self-maintenance and maintenance in concert with health professionals)
  • skills and competencies for providers fitting and maintaining pessaries
  • guidelines for pessary management from professional organization

Steering Committee Advisor
Heidi Brown (USA)
Committee Chair
Angela Rantell (UK)          
Committee Members
Zeelha Abdool (South Africa)
Morgan Fullerton (USA)
Abel Gedefaw (Ethiopia)

Kate Lough (UK)
Paweł Miotła (Poland)
Narmin Mukhtarova (USA)
Patricia Neumann (Australia)
Jordan Spencer (USA)

2. Pelvic Floor Muscle Training (Physiotherapy, Biofeedback)
This committee evaluated the mechanisms and evidence for pelvic floor muscle training in prevention and treatment of pelvic organ prolapse (POP) separated into anatomic (POP-Q stage) and symptomatic POP. Furthermore, the evidence for pelvic floor muscle training in conjunction with prolapse surgery was explored. Evidence from randomized controlled trials only was reviewed. The report details the pelvic floor muscle training protocols used and aims to make recommendations for effective pelvic floor muscle training in treatment of POP.

Steering Committee Advisor
Chantal Dumoulin (Canada)
Committee Chair
Kari Bo (Norway)
Committee Members
Cristine Homsi Jorge Ferreira (Brazil)
Jennifer Kruger (New Zealand)
Achla Batra (India)
Yi Ling Chan (UK)
Ingeborg Brækken (Norway)
Manisha Yadav (Nepal)
Sonia Angles (Spain)

3. Weight loss/lifestyle modifications/Mind body therapy (central desensitization)
This committee will explore the impact of lifestyle changes on the prevention and treatment of pelvic organ prolapse. This chapter will focus on 1) the impact of lifestyle factors on the mechanics associated with preventing and developing pelvic organ prolapse, 2) the effects of lifestyle modifications on symptom severity and objective physical exam finding, and 3) the data regarding postoperative duration and efficacy of lifestyle modifications/restrictions following prolapse surgery.  

Steering Committee Advisor
Sarah Collins (USA)
Committee Co- Chairs
Vivian Sung (USA)  
Peter Jeppson (USA)
Committee Members  
Lori Forner (Australia)
Jenny Thompson (USA)
Thomas Wheeler (USA)
Delena Caagbay (Australia)
Tyler Muffly (USA)
Isuzu Meyer (USA)
Sunil Balgobin (USA)


The duration of the commitment is 3 years. The committees will be formed in August-September 2020 and will begin working together shortly thereafter.

Each committee will be invited to meet in person at the 2021 IUGA Annual Meeting in Singapore. A private meeting room will be provided for a half day (4 hours) to finalize the scope of the report. After scope of the report is finalized, each committee will present their ideas to the attendees of the IUGA Annual Meeting at a dedicated consultation session. Each committee will have 10 minutes to present their ideas followed by 5 minutes of questions and discussion with the audience.

After the consultation sessions at the IUGA Annual Meeting in 2021, the committee will have 12 months to finalize their recommendations and write the manuscript. This final work may be presented by the committee at the IUGA Annual Meeting in Austin, TX, USA in 2022. Immediately following the Annual Meeting, the final manuscript will be submitted to the IUJ in 2022 with the aim to be published in the beginning of 2023.


  • The manuscripts will be developed using a collaborative process that requires regular communication email, periodic conference calls, and completion of assignments. Although many communications will be by email, Committee Chairs and Members are required to participate in teleconferences and in-person meetings.
  • Committee Members will thoroughly research their topic or sub-topic, as specified by chair.
  • Committee Members commit to produce and deliver all completed assignments and required information before the specified and agreed upon deadlines.
  • Committee Chairs and Members will disclose all potential Conflicts of Interest. To see the IUGA Conflict of Interest policy, please click here.
  • To see Committee Member Terms of Reference, please click here.

The committee, Committee Chair, and Committee Members are expected to meet all deadlines unless there are extenuating circumstances. In those cases, the Committee Chair is required to notify of their Steering Committee Member, Steering Committee Chairs and the IUGA Office before the missed deadline or as soon as is possible following the deadline. Any Committee Chair or Committee Member that does not meet these requirements, is unresponsive to more than 4 consecutive emails, or does not remain in regular contact with the Steering Committee and IUGA Office will be promptly replaced.