The following blog is taken from the PESSARY GUIDELINES. This is an information blog only and NOT a substitute for medical advice. Please get in touch with myself, your local pelvic floor physio trained in pessary management, your GP or Gynaecologist to discuss you individual symtpom’s.
If you have never seen or heard of a vaginal pessary you are probably looking at this picture with a slight WTF?!? Expression on your face….let me explain.
These blue magic little devices are support pessaries for vaginal prolapse and stress incontinence that can be made from silicon, rubber or plastic.
“Pessaries are considered to be a relatively safe method of managing pelvic organ prolapse without serious side effects (Atnip 2009; Hanson et al 2006; Vierhout 2004; Gorti et al 2009; Fernando et al 2006; Sitavarin et al 2009).” and “are a first-line management option for women with pelvic organ prolapse:
with symptomatic pelvic organ prolapse
who decline surgery
who are unfit for or awaiting surgery
who have failed surgery
who have not completed childbearing
who are pregnant or postpartum
who are of older age and with co-morbidities.”
In a nutshell, these nifty little things are scaffolding for the vagina and help support the vaginal walls/pelvic organs when prolapse is an issue. Now before you read this and think “yay a cure” there’s a bit more to these pessaries. Not ever women needs one or will benefit from one, and you need to look after them. The can be a fantastic option to manage symptoms for some women (see the bullet points above).
If I think a patient would benefit from a pessary, or they have been referred by another physio/GP/gynaecologist I first need to do an initial assessment taking their full medical and pelvic history and completing a vaginal exam. An appointment with their GP and/or Gynae will be needed prior to fitting a pessary too. But once this is all done, the fitting can begin.
The blue pessaries above are my fitting kits. I have a range of different sizes and shapes of pessary and I need to find the perfect one for the patient. These kits allow me to trial different shapes and sizes, and check they fit well, you can laugh, cough, sneeze, pee without discomfort or the pessary falling out. I’ll also get you to move around, try some exercise (harder exercises if you are wearing them to play sport) and once we get the right fit, you get a brand new white silicon pessary to take home. During the fitting appointment, I will teach you how to insert and remove your pessary, clean it and look after it. The blue pessaires I then clean and sterilise afterwards.
I will see you a few more times to check the pessary is working for you and then life goes on until it’s been 12 months (or sooner if you have any issues) and you come back in for you yearly pessary WOF.
Which one is the best for you? Like everything else in Woman’s Health it really does depend on the individual so a detailed assessment is needed. The change this can make to a woman’s life when they are dealing with prolapse and/or incontinence is worth the time and patience!