Treatments

Pessaries are used in the management of pelvic organ prolapse. Some women wear them all the time and some women just need a little extra support when doing sport, imagine it like using a sports bra. Pessaries come in lots of different shapes and sizes as do vaginas and are there to help relief from pelvic organ prolapse symptoms.

Pessaries are another management tool along with strengthening and conditioning of the pelvic floor muscles. A good pelvic floor muscle function is still very important as your pessary can fall down/out.

What happens during an appointment?

An appointment with one of our team can be between 1-1.5hours long and will include:

• A short briefing on symptoms and current management. A discussion around your medical history should’ve already taken place.*
• Discuss indications and contraindications of pessary use.
• An alignment assessment – including movement such as walking, lifting, carrying.
• Breathing assessment - how the ribs, diaphragm, stomach move in conjunction with one another
• Abdominal separation assessment.
• An internal examination to assess pelvic floor strength, co-ordination and timing.
• Measurement of the prolapse - helpful when choosing the appropriate pessary but gives a baseline measurement to compare with in the future. This may involve patient to be side lying and use of half a speculum.
• Discuss which pessary would be suitable and the fitting shall commence.
• You'll then be asked to get and have a walk around the room, go outside and walk down the road, sometimes run if the pessary is for sporting use.
• A standing assessment is carried out to see where the pessary is sitting in a functional position.
• If the pessary is in a good position and comfortable, you'll be shown how to self-manage a pessary – how to insert and remove.
• If the pessary is not sitting in a satisfactory position then your physio will trial a different size and in some cases a different type.

Our Physio team recommend coming back to clinic 2 weeks later for a follow up to discuss how things are doing, check the pessary and answer any questions. Pelvic floor programme’s will be adjusted and progressed if needed. Follow up appointments are usually booked at 3, 6 and 12 months.

What do I need to bring to the appointment?

If you participate in any active training or sport, then please bring a pair of trainers to the session as your physio may carry out relevant testing to your activity. 

If you've already seen a medical professional regarding a pessary fitting or have had any investigations relating to your pelvic health, please see below.*

Our pessary fitting service costs £200 (exluding pessary, cost vary depending on type of pessary). Pessary fittings are not covered by insurance companies and the clinic will be unable to claim via BUPA/AXA. A £100 non-refundable deposit is payable at the time of booking. We are happy to re-schedule your appointment but kindly ask that you allow us at least 5 working days to do so. Deposits are not refundable if you decide to cancel you appointment.

*If you have recently been assessed by a women’s health specialist and been recommended for a pessary then you may be eligible to attend a pessary fitting on your first appointment. Patients will be sent an online form to complete and one of our team will be in touch with the disclosed healthcare specialist for a patient handover. Our team will determine if you can come in for a pessary fitting without an assessment and will be in touch.  

If you haven’t already seen a women’s health specialist, all patients will need to book an initial women’s health assessment first, before a pessary appointment is considered.  

For more detailed information about pessaries please read our helpful blog.