What is a Pessary?

So, your doctor prescribed you a pessary? What does that mean? A pessary is small device inserted into a woman’s vagina that helps with incontinence or prolapse. Pessaries are most commonly given to patients with uterine prolapses, which means your uterus sags into the vaginal canal. This prolapse can be caused by weak muscles or ligaments which may happen after child birth, pelvic surgery, or straining from chronic constipation. Pessaries can also be used for cystoceles or rectoceles (which are different types of prolapses). A pessary is a great non-surgical way to help support your internal organs. Like shoes, there are many different sizes and shapes of pessaries. You must find the perfect fit, which often requires a trial and error period with your doctor.

Types of Pessaries
The pessary is custom fit to the individual, however, there are many different varieties. A ring is easy to insert and remove and is commonly recommended for women. A gellhorn pessary is ring shaped with a knob in the middle and is used for more severe prolapses. A doctor may be needed to insert and remove a gellhorn pessary. Other varieties include the gehrung (U-shaped) and cube (for advanced prolapses) pessaries. Again, it may be necessary to talk with your doctor and try several different types before you find the right fit for you.

This Doesn’t Feel Quite Right?
When first using a pessary, it is normal to experience some pressure. However, this pressure should go away within several days and then resolve. A pessary should be comfortable and unnoticeable. If you experience pain, or the pessary slips out when bearing down/having a bowel movement, make sure to visit your doctor to be re-evaluated, as another type or shape may

be recommended. It is okay to wear your pessary during intercourse, but it may be more comfortable if the device is removed.

How Do I Clean My Pessary?
Side effects of pessaries include foul smelling discharge, vaginal irritation or urinary tract infections, however, these side effects can often be prevented by frequently removing and cleaning your pessary. Most pessaries can be self removed. If this is the case, remove the pessary once a day or several times a week and wash it with soap and water. In order to remove your pessary,

use your finger to hook under the rim and pull the device down and out. If your pessary falls into the toilet after a bowel movement, soak the device for 20 minutes in rubbing alcohol, then again for 20 minutes in water and wash and dry the device before inserting it again to prevent contamination. If your doctor must remove your pessary, make sure to get it removed every other month for cleaning. It is not recommended to keep the pessary in for more than 3 months without removal.

References

Information for Women - Pessary. http://www.sasksurgery.ca/pdf/pessary-info.pdf.

Pessary Patient Instructions - Brigham and Women’s Hospital. https://www.brighamandwomens.org/obgyn/urogynecology/forms-and-education-materials/pessary- instructions. Accessed April 3, 2019.

pessary-info.pdf. http://www.sasksurgery.ca/pdf/pessary-info.pdf. Accessed April 1, 2019.

Pessary: Insertion, Types, Side Effects, and Care. https://www.healthline.com/health/pessary#benefits-and-side-effects. Accessed April 8, 2019.

Types of pessaries. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary- incontinence/multimedia/pessary-use/img-20006056. Accessed April 3, 2019.

Vaginal Pessary Rings: Types, Purpose, Care, Risks, & Complications. https://www.webmd.com/urinary-incontinence-oab/what-are-vaginal-pessaries#1. Accessed April 1, 2019.

Vaginal Pessary for Pelvic Organ Prolapse. familydoctor.org. https://familydoctor.org/vaginal- pessary/. Published September 1, 2000. Accessed April 8, 2019.

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