- Sarah K. Girardi, MD, FACS
Part I. General Information
What is a pessary?
A pessary is a device that fits into the vagina to help support the uterus, vagina, bladder or rectum. This improves incontinence and bladder emptying.
What are pessaries made of?
Silicone and they are flexible.
Why is it used?
As women age, their pelvic organs may drop down or sag. This is called "prolapse". Women may have difficulty emptying their bladders or find that they have unwanted urine leakage. These symptoms can be relieved with a pessary.
What does a pessary look like?
Pessaries come in many shapes, but are usually round. They can be cube or "u" shaped.
Can a pessary hurt me?
No, you should not be able to feel a pessary when it is placed inside you. It does not cause infection and there are no known long-term problems associates with pessary use.
Does the pessary have to be cleaned?
Yes. The pessary should be cleaned on a regular basis. Some patients prefer to do this themselves, and others prefer that we take care of the pessary. If we care for the pessary, we remove it and clean it every 3 months
Will I need to douche when I use a pessary?
No, but if you have a discharge, a vinegar and water douche might be used so that the pessary is more comfortable and less irritating. Trimo-san, a cleansing deodorant, may be recommended. You may also need to use estrogen cream.
Can the pessary get lost or fall out?
The vagina is a closed tube. The pessary can’t go anywhere else inside the body. The pessary can fall out of the vagina if you strain or lift something.
What kind of pessary will I use?
The type of pessary depends on the problem you have. The pessary has to fit just right. The pessary is fit by trial and error. It usually takes a few tries to get the right one.
Part II. Care Of Your Pessary
How do I put it in, remove, and care for my pessary?
Empty your bladder before putting in or removing your pessary. Find the position easiest for you to remove it. Usually, women lie down, squat on a toilet, or lift and support one leg on a chair, stool, or the toilet.
When putting in your pessary, put water-soluble, lubricating jelly on the tip of the pessary, which will enter the vagina first. Then with one hand, hold pessary, and with your other hand, open your vagina. Then firmly push the pessary up and into your vagina. The pessary may have to be pushed further in the vagina so that it is behind the pubic bone.
When removing your pessary, put 2 fingers in your vagina and grab the pessary, slowly turn it as you pull it down and out.
Wash the pessary with soap and water. Dry it. It is then ready to be inserted again.
For further instructions, please read How to Insert a Pessary.
Part III. Other Important Points About Pessaries
What do I do if the pessary falls out?
If you strain to have a bowel movement and accidentally expel the pessary, do not flush the pessary down the toilet. Put gloves on and remove it from the toilet, put into a zip lock bag, and take it with you to your next appointment. A larger or different pessary may be necessary.
Can I have sexual intercourse with the pessary in place?
Most pessaries can be worn during intercourse. – Be sure to tell your doctor if you are sexually active so that the appropriate pessary may be selected.
What if I experience vaginal bleeding?
Scant vaginal bleeding can occur with a pessary as it rubs against the vaginal walls that are thin with aging. Sometimes an estrogen cream is recommended. Rarely, the pessary is removed for two to four weeks while the vaginal lining heals.
What if you can't find a pessary that fits?
The only options if a pessary cannot work are surgical repair of prolapse or observation.
Is there any follow-up?
If we clean your pessary, it is done every three (3) months in the office. The appointment takes five minutes and involves a brief physician examination. If you care for your pessary, follow-up is yearly.
For more information, or to make an appointment, please call 516.320.7040.