Vaginal Pessary

What is a vaginal pessary?

A vaginal pessary is a device inserted into the vagina (birth canal) to help support the vaginal walls and pelvic organs. The pessary presses against the walls of the vagina. A pessary may be made of plastic or rubber. It may be a round or egg-shaped ring, it may look more like a donut, or it may be other shapes like a mushroom. Some pessaries are inflatable and may be easier to insert than the plastic or rubber devices.

What is it used for?

A vaginal pessary is a nonsurgical way to treat certain problems caused by weak pelvic muscles, such as:

• prolapsed uterus, which is a uterus that has fallen out of place and down into the birth canal
• urinary incontinence, which is uncontrollable leaking of urine from the bladder
• a cystocele, which is a type of hernia in which the bladder pushes against weakened tissue in the front wall of the vagina
• a rectocele, which is another type of hernia in which the rectum pushes against weakened tissues in the back wall of the vagina

The pessary may be used temporarily before surgical treatment for some of these problems, or it may be used instead of surgery when surgical treatment isn't desired or feasible.

How is it used?

Your healthcare provider will insert the pessary into your vagina or show you how to do it yourself. Usually a pessary should be removed, cleaned, and reinserted every 2 to 4 weeks.

The pessary may stretch the vaginal walls so that the vagina becomes bigger after some time. If this happens, you will need to see your provider to be refitted for a larger pessary.

What are the benefits?

• The vaginal pessary helps to keep the pelvic organs in place.
• It reduces the discomfort caused by a prolapsed uterus, bladder, or rectum.
• It may help prevent leaking of urine.
• If used before surgery, it can allow you to schedule surgery at a convenient time. It also gives your healthcare provider more time to treat any vaginal infections or to build up the vaginal tissue lining with estrogen cream to help healing after surgery.

What problems can pessaries cause?

Pessaries can cause:

• irritation of the vagina
• vaginal discomfort
• infections of the vagina
• small sores in the vagina, which might cause bleeding or a discharge with an odor

These problems are common because usually women who need a pessary have gone through menopause and their vaginal lining is thin and more easily injured. These problems can be prevented by using estrogen cream in the vagina to make the lining thicker and healthier.

Call your healthcare provider if:

• You have any bleeding.
• You have a discharge with an odor.
• The pessary feels uncomfortable or it falls out.