Vaginal Pessary

A vaginal pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder, or rectum.

 

The pessary is most often used for prolapse of the uterus. Prolapse means that your uterus droops or sags into the vaginal canal. This happens because the muscles and ligaments that should support it are weak. These muscles may get weak after you give birth or have pelvic surgery. Prolapse of the uterus is usually fixed with surgery. But you can also use a vaginal pessary to help keep the uterus in place.

A pessary can help if you have a cystocele. This is when your bladder droops down into your vagina. It can also help if you have a rectocele. This is when the wall of your rectum bulges into the bottom of your vagina.

In addition, a pessary can help many women who have stress urinary incontinence. This is the leaking of urine when you cough, strain, or exercise. Pregnant women who have incontinence can also use a vaginal pessary.

Path to improved health

Your doctor will decide which type of pessary you should use depending on the problem you have. The pessary has to be fit just right in order to work correctly and be comfortable. Your doctor will fit you with several different sized pessaries until he or she finds one that fits best.

After the first fitting, you’ll need to go back to the doctor’s office in a few days to have the pessary rechecked. After that, you will probably be checked every few months. Sometimes the size or shape of the pessary will have to be changed.

How do I care for my vaginal pessary?

It’s important that you follow your doctor’s instructions about caring for your pessary. You can wear most pessaries for many days before taking them out and cleaning them with simple soap and water. You may be able to take out, clean and reinsert your pessary yourself. Or your doctor may want you to come into the office so he or she can do it. Be sure to keep your check-up appointments and clean the pessary as your doctor tells you.

What else should I know?

Many vaginal pessaries can be worn during intercourse — your doctor will tell you if yours cannot. Be sure to tell your doctor promptly if you have any discomfort with the pessary. Also let him or her know if you have trouble urinating or having a bowel movement.

Things to consider

You may notice more vaginal discharge than normal when using a pessary. Your vaginal discharge may also develop an odor. Certain vaginal gels can help with these side effects. Cleaning your pessary more often may also help with foul-smelling odor.

Vaginal irritation is another possible side effect. Women who are past menopause may need to use estrogen cream to help relieve the irritation.

Can the pessary get lost or fall out?

The vagina is a closed tube. The pessary can’t go anywhere else inside the body. However, the pessary can fall out of the vagina if you strain too hard or lift something heavy. This usually means that your pessary is too small. Check with your doctor if your pessary keeps falling out.

Questions to ask your doctor

  • Am I a good candidate for a vaginal pessary?
  • Why should I choose a vaginal pessary over corrective surgery?
  • Will a vaginal pessary make sex uncomfortable?
  • Will using a vaginal pessary put me at risk for urinary tract infections or vaginal infections?
  • How will I know if the vaginal pessary slips out of place?

Resources

National Institutes of Health, MedlinePlus: Uterine Prolapse