Microsoft word - pessary.doc
A pessary is a plastic de vice 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 or vagina. Prolapse
means that the uterus or vagina droops or tends to "fall out" because it loses
support. This problem can be fixed with surgery or you can use a pessary to
help keep the uterus and vagina in place.
A pessary can help if you have a "cystocele" (when your bladder droops down
into your vagina) and in certain cases, if you have a "rectocele" (when your
rectum sticks up into the bottom of your vagina).
A pessary may also help women with stress urinary incontinence (the leaking of urine when you cough,
strain or exercise). Pregnant women with incontinence can also use a pessary.
First- and second-degree prolapse are usually managed with a ring pessary. The Gellhorn pessary is
designed to manage severe uterine or vaginal prolapse. The Gellhorn pessary offers stronger support, but
it is a little more difficult to remove than the ring pessary.
After the first fitting, you'll need to return to have the pessary rechecked. Your doctor will check to be
sure the pessary is not causing irritation to the vagina and will evaluate the fit of the pessary after you
have worn it for a few days. After the follow up appointment, you will only need to return to be checked
every few months. Sometimes the size or shape of the pessary will have to be changed over time.
How do I care for my pessary?
If you feel comfortable placing and removing the pessary, you can remove it for cleaning every one to
four weeks. The pessary can be cleaned with simple soap and water. Do not use detergents or
antibacterial sprays because they may damage the pessary.
If you are not comfortable placing and removing the pessary, you can be scheduled each month for
evaluation. Your doctor or nurse will remove the pessary for cleaning then replace it for you.
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Over time you may notice the pessary becomes somewhat discolored. This is to be expected and does
not mean the pessary is infected or will not work.
Does the pessary cause any side effects?
You may notice more vaginal discharge than normal. Your vaginal discharge may also develop an odor.
Vaginal estrogen cream can help with these side effects. The estrogen cream facilitates growth of the
normal or “good” bacteria and prevents the growth of “bad” bacteria that can create odors. Good
Vaginal irritation is another possible side effect. Women who are past menopause must use estrogen
cream as directed by your doctor. This will prevent irritation and injury to the vagina.
Can the pessary get lost or fall out?
The vagina is a closed tube. The pessary cannot go anywhere else inside the body. The pessary can fall
out of the vagina if you strain or lift something. This usually means that your pessary is too small. Check
with your doctor if your pessary keeps falling out.
What else should I know?
Many pessaries can be worn during intercourse – your doctor will tell you if you can't. Be sure to tell
your doctor promptly if you have any discomfort with the pessary, any vaginal bleeding, or if you have
trouble urinating or having a bowel movement.
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