Pessary Information

PESSARY

What’s a pessary?

A pessary is a plastic device, similar to a diaphragm that fits into the vagina to help support the uterus, bladder or rectum. It may be used to support a prolapse (bulge) temporarily while a woman awaits surgery, or as a permanent alternative to surgery by women who either do not wish surgical correction for their prolapse or are not good surgical candidates. Some women only wear the pessary for strenuous exercise like jogging or hiking because symptoms impact only these activities of daily living. It is not an “old fashioned” remedy, but a great solution for many women.

There are several different types of pessaries. Your doctor will decide which type of pessary you should use based on the problems and symptoms you are having. After inserting a pessary, your doctor will ask you to walk around, sit, and strain to see how the pessary feels to you, and if the pessary remains in place. While still in the office, you may be asked to try to urinate with the pessary in place. It often takes more than one try to find the pessary type and size that will work best for you. If a pessary fits correctly, you should hardly know it is there.

What do I do with the pessary?

After the initial fitting of a pessary, you will return to the office in a week or so to report how it is working for you. Occasionally a pessary will fall out when a woman is straining to have a bowel movement. If this happens, wash off the pessary and reinsert it after you are finished with your bowel movement. If it continues to fall out, you may need to try either another size or type of pessary. In this case, simply wash and dry the pessary, place it in a baggy, and bring it with you for your appointment with the physician. If you and your physician find another pessary that seems to work better, we will exchange pessaries at no cost to you. If your pessary seems to have moved within your vagina, do not become alarmed. After washing your hands, lie down and push the pessary up as far as you can. You can not push it into your abdomen. If this does not help, call the office.

Pessaries can be removed every night, washed with soap and water, and reinserted the next morning. Or they may remain in the vagina for 3-4 months and then be removed, cleaned and reinserted. If you wish to take care of the pessary yourself, the office staff will train you how to put in and take out your pessary, and how to care for it, during your second office visit. If you prefer, you may return to the office every few months and we will take care of it for you. You should not leave the pessary in more than 4 months without removing and cleaning.

Your physician will instruct you about routine follow up visits. During that visit, the physician will remove the pessary and check the vagina for any irritation that might be caused by the pessary.

Some pessaries can be worn during intercourse. Check with your physician if this is a concern.

Will wearing a pessary cause any problems?

Because a pessary is a foreign object in the body, you may notice more vaginal discharge than normal, and this discharge may have an odor. Certain vaginal gels may help with this problem, so check with your physician. It is not necessary or recommended to douche while using a pessary, and may actually cause more harm than good. You can take a bath with a pessary in place. Using feminine hygiene sprays or perfumed or deodorant sanitary products is also not recommended as they may irritate this sensitive area. If the discharge causes irritation, itchiness or burning in or around your vagina, or is stained with blood when you are not having your period, you should notify the office.

Some women experience some irritation in the vagina when wearing a pessary. Your physician may prescribe estrogen cream to insert into the vagina every few days which may help strengthen the walls of the vagina and help with this irritation. If a pessary is left in the vagina for too long, it can irritate the vaginal walls. This is why we recommend regular visits to the office so that your physician can check for any irritation. If this happens in between visits, you should contact the office.

Wearing a pessary should not cause any swelling, soreness or redness of your perineal area (area around your urethra and vagina), or pain and itching when you urinate. If you experience any of these symptoms, please notify the office.

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