A pessary is a medical device inserted into the vagina to provide support for the uterus, bladder, or rectum. It is commonly used to treat pelvic organ prolapse and stress urinary incontinence. Pessary fitting is a non-surgical option that helps improve symptoms and enhance comfort.
Types of Pessaries
- Ring Pessary: The most common type; used for mild to moderate prolapse.
- Gellhorn Pessary: Used for more advanced prolapse; has a knob to keep it in place.
- Cube Pessary: Used for severe prolapse; provides suction to stay in place.
- Donut Pessary: Suitable for more severe prolapse and older patients.
- Inflatable Pessary: Filled with air for easier insertion and comfort.
When is a Pessary Recommended?
- Pelvic Organ Prolapse: Provides support for prolapsed bladder, uterus, or rectum.
- Stress Urinary Incontinence: Helps prevent urine leakage during physical activity.
- Postpartum Recovery: Supports weakened pelvic tissues after childbirth.
- Inoperable Prolapse: For patients not suitable for surgery due to health conditions.
- Temporary Support: Used to manage symptoms until surgery is performed.
How is a Pessary Fitted?
- Pelvic Exam: The doctor examines the vaginal walls and pelvic organs.
- Size Selection: The right size and type of pessary is selected based on the patient’s anatomy.
- Insertion: The pessary is inserted into the vagina and adjusted for comfort.
- Testing: The patient is asked to walk, sit, and cough to check for fit and comfort.
- Education: The patient is taught how to remove, clean, and reinsert the pessary.
- Follow-Up: A follow-up visit is scheduled to check for any irritation or discomfort.
Benefits of Pessary Fitting
- Non-surgical treatment option.
- Immediate relief from prolapse and incontinence symptoms.
- Preserves sexual function and comfort.
- Can be easily removed and adjusted if necessary.
- Safe for use in elderly patients or those with health issues.
- Helps prevent worsening of prolapse over time.
Risks and Complications
- Vaginal irritation or discharge.
- Pressure sores in the vaginal walls.
- Difficulty inserting or removing the pessary.
- Urinary tract infections (UTIs).
- Bleeding or spotting.
- Need for size adjustment if discomfort occurs.
Frequently Asked Questions
1. How long can I wear a pessary?
Most pessaries can be worn continuously for several weeks, but they should be cleaned regularly as instructed by your doctor.
2. Can I have intercourse with a pessary?
Yes, some types of pessaries, such as the ring pessary, can be left in place during intercourse.
3. How do I know if my pessary is the right size?
If you feel discomfort, pain, or notice it falling out, the size may need to be adjusted.
4. Can a pessary fall out?
Yes, if the pessary is too small or not inserted correctly, it may fall out during activity.
5. Do I need to remove the pessary at night?
Some pessaries can be worn continuously, while others should be removed at night. Follow your doctor’s advice.
6. Can a pessary cause infection?
Improper cleaning or prolonged wear without removal can increase the risk of infection.
7. Is a pessary painful?
A well-fitted pessary should not cause pain. If you experience discomfort, consult your doctor.