A pessary is a small device made of silicone, often shaped like a diaphragm or a cube, which is inserted into the vagina of a woman to help support her pelvic organs. Pessaries are used to treat pelvic organ prolapse (POP) and urinary incontinence.
A health professional will need to fit you for the device. Getting the right size and shaped pessary is important. Then you will learn how to insert, remove and clean the pessary yourself. If you are not comfortable doing this yourself, you must then make appointments to return to your healthcare professional for periodic removal and cleaning of the device. Your healthcare provider will instruct you on the timing for removal and cleaning, as this is important to do, so that you do not experience complications from the device.
Pessaries are used by women to help support the vaginal walls including the bladder,urethra, uterus, and the rectum (sometimes referred to as cystocele, rectocele, enterocele, and uterine prolapse) . They are also used by women with urinary incontinence.
Why You May Wish to Try a Pessary If You Have Urinary Incontinence or Pelvic Organ Prolapse
- Pessaries are completely removable if another treatment becomes available down the road.
- The use of a pessary is less risky than surgery.
- When properly fitted, cleaned per instructions, and periodic examinations by your healthcare provider are made, this device is comfortable to use, and complications are not common.
Why You May Not Wish to Use a Pessary
- Some women are uncomfortable with the thought of being fitted for a pessary, inserting and removing the pessary on their own, or having a health care provider insert or remove the pessary. Discuss this hesitation with your health professional, as talking about it and seeing the actual device may eliminate that feeling.
- If you are a sexually active woman, you may need to remove the pessary before intercourse.
- Infection is rare but can occur if the pessary is not removed and cleaned as directed.
- Irritation can occur, especially in post-menopausal women (due to lack of estrogen and natural lubricant). However, this can usually be prevented with the use of vaginal creams.
Important – If you experience any discomfort or pain, constipation, unusual vaginal discharge, foul odor, bleeding, or irritation, contact your healthcare provider immediately. Occasionally complications arise from use of a pessary. These rare complications often are due to a poor fitting pessary (the need for a size change is common with weight loss or gain), poor condition of the vaginal tissues, and lack of follow up with the healthcare provider. Only in rare instances have complications been severe. If you and your healthcare provider are planning on your using a pessary for any length of time, ask your provider to discuss the possible complications so that you are fully informed.
Medical Reviewer: Shanna Atnip, MSN, WHNP-BC
Ms. Atnip is a Women’s Health Nurse Practitioner in the Urogynecology Division at Parkland Hospital in Dallas, Texas. At Parkland, the Urogynecology Division handles the full gamut of pelvic floor issues. Ms. Atnip has been a part of this department for sixteen years. She is a member of the Society of Urologic Nurses and Associates (SUNA) and the American Urogynecologic Society (AUGS). She has been the Southeast Regional Director of SUNA since 2011 and has served in many leadership roles within SUNA. She has also been a local and national speaker for SUNA conferences and symposia.