What is a vaginal pessary?
A vaginal pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder or rectum.
The pessary is most often used for prolapse of the uterus. Prolapse means that your uterus droops or sags into the vaginal canal because the muscles and ligaments that should support it are weak. This may occur after you give birth or have pelvic surgery. Prolapse of the uterus is usually fixed with surgery, but you can also use a vaginal pessary to help keep the uterus in place.
A pessary can help if you have a cystocele (when your bladder droops down into your vagina) or if you have a rectocele (when the wall of your rectum bulges into the bottom of your vagina).
A pessary can also help many women who have stress urinary incontinence (the leaking of urine when you cough, strain or exercise). Pregnant women who have incontinence can also use a vaginal pessary.
What kind of vaginal pessary will I use?
Your healthcare provider will decide which type of pessary you should use depending on the problem you have. The pessary has to be fit just right in order for it work correctly and be comfortable. Your healthcare provider will fit you with several different sized pessaries until they find one that fits best.
After the first fitting, you’ll need to go back to the healthcare provider’s office in a few days to have the pessary rechecked. After that you will probably be checked every few months. Sometimes the size or shape of the pessary will have to be changed.
How do I care for my vaginal pessary?
It’s important that you follow your healthcare provider’s instructions about caring for your pessary. Most pessaries can be worn for many days to weeks at a time before they have to be taken out and cleaned with simple soap and water. You may be able to take out, clean and reinsert your pessary yourself, or your healthcare provider may want you to come into the office so they can do it. Be sure to keep your check-up appointments and clean the pessary as your healthcare provider tells you.
Does the vaginal pessary cause any side effects?
You may notice more vaginal discharge than normal. Your vaginal discharge may also develop an odor. Certain vaginal gels can help with these side effects. Cleaning your pessary more often may also help with foul-smelling odor.
Vaginal irritation is another possible side effect. Women who are past menopause may need to use estrogen cream to help relieve the irritation.
Can the pessary get lost or fall out?
The vagina is a closed tube. The pessary can’t go anywhere else inside the body. However, the pessary can fall out of the vagina if you strain too hard or lift something heavy. This usually means that your pessary is too small. Contact your healthcare provider if your pessary keeps falling out.
What else should I know?
Many vaginal pessaries can be worn during intercourse — your healthcare provider will tell you if yours cannot. Be sure to contact your healthcare provider promptly if you have any discomfort with the pessary, if you have trouble urinating or having a bowel movement.
Practical Use of the Pessary by AJ Viera, LT, MC, USNR, and M Larkins-Pettigrew, LCDR, MC, USNR (American Family Physician 05/01/00, http://www.aafp.org/afp/20000501/2719.html)