Summary of findings 1. Any pessary compared to control, waiting list or no active treatment.

Any pessary compared to standard care
Patient or population: pelvic organ prolapse in women Setting: urogynaecological clinic Intervention: any pessary Comparison: standard care
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with standard care	Risk with any pessary
Perceived resolution of prolapse symptoms: ≥ 12 months	Not reported
Perceived improvement of prolapse symptoms (higher score = worse symptoms) assessed with: POP score of Australian Pelvic Floor Questionnaire range: 0‐10 Follow‐up: 12 months	The mean score in the comparator group was 0.31	MD 0.03 lower (0.61 lower to 0.55 higher)	‐	27 (1 RCT)	⊕⊝⊝⊝ VERY LOW 1 2
Prolapse‐specific quality of life ≥ 12 months	Not reported
Cure or improvement of sexual problems assessed with: sex score of the Australian Pelvic Floor Questionnaire score: 0‐10 (higher score = worse symptoms) Follow‐up: 12 months	The mean score in the comparator group was 1.45	MD 0.29 lower (1.67 lower to 1.09 higher)	‐	27 (1 RCT)	⊕⊝⊝⊝ VERY LOW 1 2
Psychological outcome measures at ≥ 12 months	Not reported
Number of women with adverse events (vaginal bleeding, voiding difficulty)	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; MD: mean difference; POP: pelvic organ prolapse; RCT: randomised controlled trial.
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

¹ Downgraded one level for risk of bias (performance and attrition bias)

² Downgraded two levels for imprecision (few participants and wide 95% CI crossing the line of no effect)