We read with great interest the recent original article entitled "The extended pessary interval for care (EPIC) study: a failed randomized clinical trial" Written by Anglim et al. [1]. We congratulate the authors for their interesting study that described study design flaws and limited outcomes of a randomized trial that intended to compare satisfaction and complication rates between patients managing their pelvic organ prolapse with a pessary at different maintenance intervals. Although they approached a very pertinent topic in a scientific manner, we want the authors to pay attention to some issues. It was better that patients' self-care was not excluded [2] and self-care was considered as a interfering variable and random allocation of patients would reduce the bias. One reason for not achieving sufficient sample size is the omission of these individuals. It was better to check the questionnaire in terms of validity and reliability and to give it to patients in a pilot study [3]. If the pilot study Roksana Janghorban