Pessary information

18th September 2017

Our women's health physiotherapist and pessary fitting expert Sophie Vohralik shares useful information about pessary fitting to help support a prolapse.

What is a pessary?

A pessary is a silicone device that fits into the vagina to help support a prolapse of the uterus (womb), bladder and/or rectum (bottom of the bowel). A prolapse develops when one or more of the pelvic organs loses its ligamentous support so that it pushes down into the vagina. Prolapse is commonly caused by childbirth, aging, or following pelvic surgery and may take years to develop. Changes due to ageing and repeated force such as chronic coughing or straining can gradually worsen the prolapse over many years until it becomes noticeable. Typically the symptoms of a prolapse are a feeling of heaviness or bulging around the vagina. It may also limit your ability to empty your bladder or bowel.

A pessary is a conservative, low risk measure to help support the prolapse, and is akin to wearing a knee guard if you had ligament issues in your knee. It can be very useful to help you continue chosen activities which may typically worsen a prolapse, or it may be necessary to wear the pessary all the time. Your physiotherapist will help determine what the best course of action for you will be.

 

What kind of pessary will I use?

The decision about which type of pessary each woman should use depends on the type of prolapse and the symptoms it causes. The pessary has to be fitted correctly and it may take several tries to get the right one.

After the first fitting, you will need to return to our clinic in 2 weeks time to have the pessary checked. After that you will need to be checked every 3 months. Sometimes a different size or shape of pessary will have to be fitted, as things may improve or change over time.

This is a pessary trial and most women will find a pessary that fits although occasionally this might not be the case.

 

Does the pessary cause any side effects?

Most of the potential side effects of using a pessary are very low risk. However, it’s important you are aware of them and can remove the pessary if required.

You may notice more vaginal discharge than normal. Your vaginal discharge may also develop an odour. Vaginal irritation is another possible side effect. Women who are past menopause may need to use oestrogen cream.

If you have a bad vaginal odour, lots of discharge or blood, you should immediately remove the pessary and contact your health care provider.

 

Can the pessary get lost or fall out?

The vagina is a closed tube so that the pessary can't go anywhere else inside the body. The pessary can fall out of the vagina, for example, if you strain on the toilet or bend or squat to lift something heavy. This usually means that your pessary is too small. Check in the toilet that it hasn’t fallen out (retrieve it if it has as it can be sterilised and reused). You can also hold one hand under the vaginal opening when using your bowels to keep the pessary in place. Consult your pelvic physiotherapist if your pessary continues to fall out.

 

What else should I know?

Be sure to tell your physiotherapist straight away if you have any discomfort with the pessary or if you have trouble urinating or having a bowel movement.

  • You should continue with pelvic floor exercises as prescribed by your physiotherapist

 

A pessary fitting appointment will take 45 minutes and will include a full prolapse assessment. Measurements will be recorded for a baseline and subsequent appointments will compare the measurements to monitor changes over time. The appointment costs £205 and includes the comprehensive assessment, a pessary fitting (including the pessary you take home), cleaning and sterilisation of the fitting kits as well as administrative requirements associated with pessary use. Subsequent appointments will be 30 minutes unless otherwise discussed with Sophie.

A letter will be written to you doctor or specialist explaining the fitting and ongoing management plan. (Please advise us if you do not wish for us to communicate with other health professionals regarding your prolapse/pessary fitting).

If you are a current White Hart Clinic patient and have not seen Sophie, you will need to see her for a 30 minute assessment to ascertain if you are an appropriate candidate for a pessary. She will discuss this with you in this appointment and a treatment plan will be formed.

 

Appointments with our pessary fitting specialist, Sophie Vohralik, can be booked by calling reception on 020 8876 9897.

 

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