what is a pessary

3 min read 12-03-2025

Meta Description: Discover what a pessary is, its various types, uses (including uterine prolapse, bladder prolapse, and pelvic organ prolapse), insertion, potential side effects, and alternatives. Learn when to see a doctor and make informed decisions about your pelvic health. (158 characters)

Pessaries are medical devices used to support the pelvic organs. They are often prescribed to treat conditions like uterine prolapse, bladder prolapse, and other forms of pelvic organ prolapse. This comprehensive guide will explore what pessaries are, their different types, how they're used, and what to expect.

What are Pessaries?

A pessary is a medical device, typically made of silicone or other medical-grade materials, inserted into the vagina to support the pelvic organs. Think of it as a kind of internal support system. These organs, including the bladder, uterus, and rectum, can sometimes weaken and descend into the vagina, leading to prolapse. A pessary helps hold these organs in their correct position, relieving discomfort and improving symptoms.

Types of Pessaries

Several types of pessaries exist, each designed for different purposes and levels of prolapse severity. Your doctor will determine the best type based on your individual needs and anatomy. Common types include:

Ring Pessaries: A simple, circular ring that provides general support.
Donut Pessaries: Similar to a ring but with a central hole to avoid pressure on the urethra.
Cube Pessaries: Offer more support for heavier prolapse.
Gellhorn Pessaries: A flexible, hourglass-shaped pessary.
Piston Pessaries: Designed for more severe prolapse.

Choosing the right pessary is crucial. Your doctor will perform a thorough examination to assess the degree of prolapse and your overall pelvic health. They will then recommend the most suitable type and size.

What Conditions Do Pessaries Treat?

Pessaries are primarily used to treat various types of pelvic organ prolapse, including:

Uterine Prolapse: Where the uterus descends into the vagina.
Cystocele (Bladder Prolapse): When the bladder bulges into the vagina.
Rectocele (Rectal Prolapse): When the rectum bulges into the vagina.
Enterocele: A bulge of the small intestine into the vagina.

It's important to remember that pessaries treat the symptoms of prolapse, not the underlying cause.

How are Pessaries Inserted and Removed?

Insertion and removal of a pessary are typically done by a healthcare professional, at least initially. They will show you the correct technique, and with practice, you may be able to manage this yourself. Improper insertion or removal can cause injury or discomfort. Regular follow-up appointments are vital to ensure the pessary is fitting correctly and to check for any complications.

How to Insert a Pessary (General Guidance - Consult your Doctor):

This is a simplified explanation and should not be considered a substitute for professional medical instruction. Your healthcare provider will give you personalized guidance:

Wash your hands thoroughly.
Lubricate the pessary and the vagina.
Insert the pessary slowly and gently.
Check for comfort and proper positioning.

Removal (Again, consult your healthcare provider for specific instructions):

Similar to insertion, removal requires careful technique to avoid injury. Your doctor will demonstrate the correct method, emphasizing gentleness and cleanliness.

Potential Side Effects of Pessaries

While generally safe, pessaries can cause some side effects, including:

Vaginal Irritation or Discharge: This is relatively common and often resolves with time.
Bleeding or Spotting: This can occur, particularly after insertion or adjustment.
Pain or Discomfort: Proper fitting and positioning are crucial to minimize discomfort.
Infection: Maintaining good hygiene is vital to prevent infection.
Ulcers: Rare but possible with improper use or fitting.

If you experience any significant side effects or discomfort, contact your doctor immediately.

Alternatives to Pessaries

Depending on the severity of your prolapse and your overall health, there may be other treatment options, including:

Pelvic Floor Exercises: These exercises can strengthen the pelvic floor muscles and help support the pelvic organs. Learn more about Kegel exercises.
Surgery: In severe cases, surgery may be necessary to repair the prolapse.

When to See a Doctor

If you experience symptoms of pelvic organ prolapse, such as pelvic pressure, bulging in the vagina, difficulty urinating or defecating, or vaginal bleeding, consult your doctor immediately. Early diagnosis and treatment can improve your quality of life. Regular checkups are crucial, especially if you're using a pessary.

Conclusion

Pessaries are valuable tools for managing pelvic organ prolapse. Understanding the different types, their insertion and removal, potential side effects, and alternative treatments is crucial for informed decision-making. Always consult with your healthcare provider to determine the best course of action for your specific situation. Remember, they are experts in this area and can provide personalized guidance and care. Don't hesitate to ask questions and ensure you understand the entire process before using a pessary.