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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