The POMEGRANATE Trial: A Randomized Controlled Trial Comparing Pessary Home Management of Reia Pessary Versus Standard of Care Pessary for Treatment of Pelvic Organ Prolapse
Medstar Health Research Institute
Summary
This multi-centered, randomized controlled trial will evaluate the safety and efficacy of home use of the novel Reia System (RS), which includes the Reia pessary and applicator, compared to standard pessary care (Gellhorn or ring with/without support without knob) among women with stage II-IV pelvic organ prolapse (POP). A total of 200 participants will be recruited among pessary naïve patients who are symptomatic and choose a vaginal pessary for management of their POP from study sites specializing in Urogynecology and Reconstructive Pelvic Surgery (URPS). Participants will be assigned via 1:1 randomization using computer generated numbers in permutated groups of variable block sizes to either the intervention (the Reia System, RS) or standard pessary care (SPC) stratified by site. Participation in this trial will involve a total of four visits over six months. The primary outcome measure will be satisfaction measured at the six-month time point. Secondary outcomes will include validated surveys to assess quality of life, number of self-management events, ease/difficulty of pessary insertion/removal, importance of ability to self-manage pessary, and adverse events. Specific Aims Aim 1: To compare satisfaction with pessary use and management between subjects randomized to the Reia System and those randomized to standard of care pessary. Aim 2: To assess successful fitting, number of refitting visits, number of self-management events and continued pessary use over a 6-month period between subjects randomized to the Reia System and those randomized to standard of care pessary. Aim 3: To compare ease/difficulty of pessary use and importance of ability to self-manage, as well as quality of life over a 6-month period between subjects randomized to the Reia System and those randomized to standard of care pessary. Aim 4: To measure rates of adverse events and risk factors for adverse events over a 6-month period between subjects randomized to the Reia System and those randomized to standard of care pessary.
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * English-speaking natal females ≥ 18 years of age * Willing to self-maintain (insert/remove) pessary * Pessary naïve with Stage II-IV POP desiring conservative management with a pessary * Primary indication for use of pessary is treatment of pelvic organ prolapse Exclusion Criteria: * Primary indication for pessary use is for management of stress urinary incontinence * Prior mesh-augmented prolapse repair (i.e. transvaginal mesh, sacrocolpopexy) * Short vaginal length (TVL \< 8cm) or subjective vaginal narrowing * Vaginal fistula (e.g. rectovaginal, vesicovaginal or any…
Interventions
- DeviceReia System
Reia pessary
- DeviceStandard of Care Pessary
Gellhorn pessary or ring with/without support without knob pessary
Locations (9)
- University of Alabama at BirminghamBirmingham, Alabama
- Stanford UniversityPalo Alto, California
- MedStar HealthWashington D.C., District of Columbia
- The University of ChicagoNorthbrook, Illinois
- Dartmouth-HitchcockLebanon, New Hampshire
- University of New Mexico Health Sciences CenterAlbuquerque, New Mexico