Pessaries

Pessaries

What are they?

A pessary is a silicone device worn inside the vagina. Pessaries have been used for centuries and come in many styles and sizes. Pessaries are used to control urinary incontinence odor for support of protruding (prolapsing) organs such as your bladder, uterus, rectum or top of the vagina. If you are comfortable with a pessary, you may avoid surgery. A pessary can also control symptoms while you are waiting to receive an operation. To wear a pessary, you must be comfortable with having a foreign object in your vagina. For example, if you can wear tampons comfortably, you are a good candidate to try a pessary. You must come in for a pessary fitting, during which your nurse or doctor will determine the right shape and size for you. Pessaries are fitted by trial and error. If you are wearing the right pessary, you should not feel it inside with most activities. Once fitted, pessaries can be worn once in a while or most of the time. Most women wear them during the day and remove them at night. Your health care provider will offer to teach you how to insert and remove the pessary comfortably at the time of the fitting. If you are unable or unwilling to learn this, that does not mean you cannot have a pessary; instead you will be invited to return for regular check-ups and pessary cleaning.

Cleaning

Use warm water and mild soap. Make sure you rinse the pessary well. Store it in a clean dry place. Do not boil or disinfect the pessary.

Intercourse

Simple ring pessaries may be left in for vaginal intercourse but may cause discomfort and necessitate removal. Most other styles must be removed before intercourse.

Urination and bowel movements

Most women wearing a pessary have no trouble when passing urine or having bowel movements. The pessary does not need to be removed. If you are constipated however, you may have some pain, in which case you need to remove your pessary. You need to keep your stools soft and regular.

Discharge and Odour

Some women find that they have an increased vaginal discharge, with or without an odour, when using a pessary. Usually, this is normal and does not represent a vaginal infection. This can be controlled with various creams; please speak to your doctor or nurse about it.

Insertion and removal

Insert by folding the pessary and inserting it through the vaginal opening, aiming down towards your tailbone and pushing down on the back of the vaginal wall. Using your forefinger, guide the pessary as far back as you can, then push the pessary up and behind the pubic bone. Remove by hooking your forefinger under the edge of the ring or in a hole, and pull it down and out of the vagina.

Follow-up

All patients wearing a pessary need to have regular pelvic examinations to ensure that the pessary is not putting too much pressure on the vaginal walls. Please make sure that you have follow-up appointments booked with your nurse or doctor.

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