What is a pessary?
A pessary is a device that fits into the vagina to support the uterus, vagina, bladder, or rectum. It is most often used to lift a uterus that has prolapsed or “dropped” as a result of weak pelvic support muscles. A pessary may also help women with stress urinary incontinence, which is the leakage of urine with coughing, straining, or exercise. Made of silicone or latex, pessaries are available in more than 15 different styles. Each style is designed to correct a specific pelvic support problem. Therefore, the type of pessary chosen for each patient will depend on her specific problem.
Are pessaries difficult to care for?
No. It is important, however, to follow your physician’s instructions. Because pessaries are carefully fitted, they can be worn continuously in the vagina for many days or weeks. A well-fitted pessary should not be felt by the patient; should not dislodge with standing, squatting, or straining; and should allow urination and defecation. After initial pessary selection, physicians commonly reevaluate the vagina for pressure sores or allergic reaction. If patients are able to remove the pessary, they can remove it every few weeks and clean it with soap and water. Some patients may opt to remove it daily at bedtime and reinsert it in the morning. Patients who are unable to remove their pessaries need follow-up visits every 2 months, at which time their provider will remove the pessary, wash it, and inspect the vagina.
Are there any side effects?
Some women notice increased vaginal discharge. Specific vaginal creams and gels may be suggested to help reduce this possibility. Vaginal irritation may also occur if the pessary is too large. Proper pessary fitting and follow-up evaluation can minimize this risk.
Will I be able to have sexual intercourse?
Some designs do not interfere with sexual activity. Most commonly though, pessaries are removed prior to intercourse.
When should I call my healthcare provider?
If a patient has difficulty urinating or passing a bowel movement or if her pessary persistently falls out, she may have poorly fitting pessaries. Additionally, a patient should inform her physician of any unusual vaginal discharge or bleeding.
Gynecology and Fertility Clinic
Aston Ambulatory Care Building
5303 Harry Hines Blvd., Fifth Floor, Room U5.104
Dallas, Texas 75390-8865
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