Pessary Therapy

What is a pessary?

A pessary is a small silicone device that is inserted into the vagina to alleviate symptoms of pelvic organ prolapse or stress urinary incontinence. There are many different pessary shapes and sizes which are tailored to you and your symptoms.

To help reduce bothersome symptoms of pelvic organ prolapse, certain pessary designs work by properly lifting prolapsed organs.

For stress urinary incontinence, some pessaries can help support the urethral sphincter and reduce urinary leakage when you cough, sneeze, exercise and laugh.

It is important to know that pessaries are an alternative to surgery and will not reverse pelvic floor disorders. They simply manage the symptoms associated with your pelvic floor disorder. Pessaries can be a great option for women who aren’t ready for surgery. If you try a pessary and don’t like it, you can always talk with your surgeon about reconsidering surgery as an option to address your symptoms.

How do I know if a pessary is right for me?

After a physical exam and additional diagnostic testing, you and your urogynecology team will thoroughly discuss treatment options for your unique situation. If you decide that a pessary is the best option to address your symptoms, you will be scheduled for a pessary fitting with our advance practice provider to select the best shape and size for you. A physical examination will help determine the type and size that might work, but sometimes women will need to try a couple of different pessaries to make sure their symptoms are improved.

After the initial fitting, you will go home with your pessary and test it out for a period of time. At your follow up visit, you will learn to remove and replace your pessary. Typically, women who manage their pelvic floor disorder with a pessary will see our advance practice provider for a pessary check every six months to a year. In most cases, you can remain sexually active while you manage your symptoms with a pessary.

What are the side effects?

Pessaries are very safe if used and maintained properly.

If the device is worn for a long period of time, the vagina can develop a pressure sore. If this happens, sometimes you will be advised to remove your pessary for a short period of time to allow the vaginal skin to heal. Vaginal estrogen can also be helpful in strengthening the vaginal wall to avoid the development of a pressure sore. Your advance practice provider will discuss it with you if this is an option. It is also normal to have some vaginal discharge with a pessary. If you experience any bleeding, pain/discomfort or a foul-smelling discharge, contact your urogynecologist or advanced practice provider right away.

How successful is pessary therapy?

With a pessary, the goal is to manage the symptoms related to pelvic organ prolapse or urinary incontinence so you can get back to the social gatherings and activities you love the most.

Remember, while a pessary is effective at managing your symptoms, it does not reverse or correct pelvic floor disorders. Once the pessary is removed, your pelvic floor symptoms will return.