When pelvic organ prolapse diminishes your quality of life, Florida Center for Urogynecology offers a number of solutions to restore your well-being and alleviate your discomfort, including a vaginal pessary
WHAT IS A PESSARY?
A pessary is a small, removable silicone device that is used to help support the uterus, vagina, bladder, and rectum. A pessary is similar in appearance to a diaphragm used for birth control, though they come in different shapes and sizes.
WHEN ARE PESSARIES USED?
Pessaries can be used as a minimally invasive option for treating pelvic organ prolapse. Likewise, they can be used as a temporary solution until surgery can be performed. It is also an option for patients who are not healthy enough for surgery. A pessary may also effectively reduce urinary incontinence (when used to compress the urethra).
IS IT COMFORTABLE?
If the pessary is fitted correctly, you may not even be aware of the device. Your condition and symptoms will determine the best type for your use. To be comfortable and practical, the device must be the right size. This requires careful fitting by the providers at Florida Center for Urogynecology. After the initial fitting, you’ll return within a few weeks so that our team can make sure the device is working as expected.
ARE THERE ANY RISKS OR SIDE EFFECTS?
There are some potential risks associated with an ill-fitting pessary, including:
- Erosion of the vaginal wall, leading the formation of a fistula
- Open sores on the vaginal wall
- Vaginal discharge
The side effects are generally minimal as long as the pessary is the right type and fit, and you follow your provider’s instructions for use and care. Pessaries require ongoing care for cleaning and reinsertion if you are unable to do so on your own
WHAT SHOULD I EXPECT AFTER A PESSARY FITTING?
- Most women feel improvement in symptoms of prolapse immediately and no discomfort from the pessary once fitted properly.
- You may experience 1-2 days of minor lower abdominal cramping/discomfort.
- Although non-emergent, each of the following scenarios may occur; and if so, they require an in-office visit. Please call the office if any of the following occur:
- The lower abdominal cramping doesn’t resolve in a few days or worsens
- You are unable to empty your bladder or bowels with the pessary in place
- Vaginal bleeding occurs
- The pessary falls out
- New onset urinary incontinence with coughing, sneezing, laughing or physical activity (due to a deficient urethra being straightened with elevation of a prolapsed bladder wall)
WHEN SHOULD I FOLLOW-UP?
After your initial pessary fitting, you will be scheduled for a follow-up visit in about two to four weeks. At this visit, the following will be completed:
- Remove and clean the pessary
- Examine your vagina for any erosions
- Make sure the pessary fits well and is comfortable
- Teach you how to remove, clean and reinsert the pessary on a weekly basis, if you are motivated to do this yourself (women who choose not to remove and reinsert the pessary themselves can return to our office every three months thereafter for cleaning and assessment