If you are experiencing prolapse or stress incontinence, you may have heard about pessaries. Prolapse and incontinence pessaries are silicon devices that insert into the vagina to help support the pelvic organs and soft tissues. You can think of this like being a bra for your pelvic organs. 

Pessaries can be a very effective treatment option for prolapse and stress incontinence. They can be worn continuously or used only when symptomatic (e.g. running/ exercise). 

Pessaries do require some ongoing maintenance for removal, cleaning and reinsertion. Depending on your individual tissues and the pessary type, pessaries can often be left in place for 2-3 months at a time. This can be managed mostly by you, or by your physiotherapist with bi-monthly reviews. 

There are a number of types of pessaries. Here, we list the common ones that we fit:

Ring Pessary
By far the most common- suited to many women. Can be left in for up to 3 months at a time. Many women can still have intercourse with this fitted and self-management (or physio management) of this pessary is usually straightforward. 

Cube Pessary
This type of pessary is used for more severe types of prolapse or back vaginal wall prolapse (rectocele). This requires more frequent removal for cleaning, typically once every 1-3 days, depending on your specific situation. This pessary can be very effective, however needs to be removed prior to penetrative intercourse. 

Continence Pessaries
Ring with knob, or continence dish pessaries are both effective at improving stress incontinence (leaking with high intensity exercise, cough etc.). These pessaries can also help to support a prolapse and often can be left in for up to 3 months at a time, depending on your specific tissues. Self-management of this is usually straightforward and similar to the ring pessary. 

Gellhorn Pessary
This type of pessary is for more severe pelvic organ prolapse, or cases where other pessary types have failed. This can be again left in for up to 3 months at a time. The main downside to this pessary is that it needs to be removed for penetrative intercourse and self-management of this pessary is more difficult, but not impossible. 

Interested in a pessary? Or need more information? Book an appointment to see a pelvic floor physio. A pelvic floor physio with experience in pessaries can assess your symptoms and assess your pelvic floor to determine the suitability and potential benefit of pessaries for your specific situation.  

If you are booking in our clinic, we usually recommend booking a standard initial appointment first. This will then allow you the opportunity to discuss your pelvic floor function and pessary treatment and other treatment options in detail with your physio.

Interested in trying a pessary? Book an appointment with our pelvic floor physio to see it its right for you! To book, or to find out more information go to https://www.empowerpelvicclinic.com/pessarymanagement/