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Pessary

What is a pessary?

A piece of silicon plastic used to hold a bulge in the vaginal area (prolapse) in place behind the pelvic bone. A pessary can be used to help hold the bladder, uterus or rectum in place. It is temporary and be taken out at any time.

What are reasons for having a pessary?

  • Relief of prolapse symptoms
  • To prevent prolapse from getting worse
  • Way to manage prolapse without surgery
  • Tool to determine if surgery will help
  • Tool to determine if urinary leakage will occur with surgery
  • Way to manage prolapse until scheduling surgery is convenient

Symptoms that may be improved with a pessary

  • Vaginal bulge symptoms
  • Need to get to the bathroom right away (urinary urgency)
  • Frequent urination or overactive bladder
  • Incomplete bladder emptying
  • Recurrent urinary tract infections
  • Lower back pain

What are the risks of a pessary?

  • Infection, irritation and increase in vaginal discharge
  • Pain in pelvic area or increased fullness after pessary is fitted. This is often a sign that the pessary is too large
  • Making a hole in nearby organs (erosion) if the pessary is left in place too long

What to expect after a pessary is inserted:

  • Vaginal discharge may increase especially after initial insertion. Discharge can be brown or clear.
  • Leakage of urine with cough, sneeze, position change (stress incontinence)

Vaginal lubricants may be recommended:

  • Trimo san cream - apply in vagina two nights per week
  • Estrogen cream - apply in vagina three nights per week
  • Replens cream - apply in vagina as needed for vaginal dryness
  • Luvena - apply in vagina as needed for vaginal dryness

How often does the pessary need to be taken out?

  • Follow up two weeks after the initial fitting to recheck position of pessary and assess the vaginal tissue
  • Follow up every two to three months for pessary cleaning if cleaning done at the the office
  • Some people clean the pessary themselves at home. If managing pessary at home, take pessary out weekly and wash with warm soap and water.

    • Take pessary out prior to sexual intercourse and wash pessary with warm soap and water.
    • Some patients find comfort in taking the pessary out every night and reinserting in the morning.

When to call the office or come to the emergency room:

  • Fever > 101.5 F, burning with urination, increased frequency or urgency of urination or blood in your urine
  • Increased vaginal odor, difficulty urinating or relieving bowels
  • Pain with walking, sitting or activity
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