Pessary HF#5477

 

A pessary is a small plastic or silicone device.  It is placed into the vagina and held in place by the pelvic floor muscles.  It provides support for pelvic prolapse and stress urinary incontinence.  The Pessary works by applying pressure to the urethra (the tube that drains urine from the bladder) against the pubic bone and supporting the lower part of the bladder.

 

Pessaries remain a useful device for nonsurgical treatment.  Pelvic prolapse is a weakness in the muscles that hold your bladder, uterus, and rectum in place.  The muscle weakness can cause these organs to protrude into or outside of the vagina.  Pregnancy, childbirth, being overweight, chronic constipations, chronic cough, repetitive heavy lifting and normal age-related body changes can cause these problems.

  

Choosing an appropriate Pessary depends on the condition being treated.  Your doctor or nurse practitioner may need to try several sizes and/or styles during the fitting.

 

• Patients should only be fitted for a Pessary if they are able to come in for regular follow-up visits.  The patient must be able to insert and remove the pessary herself.
• Most pessaries can be left in place during sex.  Talk to your doctor or NP.
• If your pessary has metal parts it will need to be taken out before some tests, such as MRI or x-ray.
• You may notice slight bleeding when you take out the pessary.  You may need to use estrogen or other cream.  This can help to keep the vaginal walls healthy.
• It is okay to use a pessary if you use the Estring .  Be sure to insert the Estring  before the pessary.  Replace the Estring  every 3 months.
• If your weight changes 10 - 20 pounds or more you will need to be re-sized.
• If the pessary shows signs of wear or defects you will need a new one.

 

Follow Up

 

• Call the urology office if you develop severe constipation, large amounts of white discharge, bloody discharge, increased pain, foul odor, fever, chills, abdominal pain, painful urination, or if you are unable to urinate.
• Return to the clinic after 1 week from the first pessary fitting so that the fit can be rechecked.  The pessary will be removed and the vagina will be examined for irritation or allergic reaction.
• Return in 2 weeks and 6 months.  Some patients may need to return to the clinic more often for re-fitting.
• Yearly exam of vaginal wall.
• Call with problems or if the pessary falls out and you are unable to replace it.
  

Pessary Care

 

• Most pessaries can be worn for many days to months before they have to be taken out and cleaned.
• Clean with mild soap and warm water.  Rinse well and reinsert.  Use estrogen or other cream when the pessary is out or at least 2 nights a week.
• The pessary may fall out of the vagina if you strain or lift something.  Try not to bear down especially during bowel movements.  If the pessary dislodges, it can be reinserted after cleaning with soap and water.
• Insertion may be easier while standing with your foot resting on a stool or while sitting on the toilet or while lying on your back.  Make sure to use an adequate amount of water-based lubricant with insertion.

 

Pessary Type: __________________________________________
Pessary Size: ___________________________________________

When to Call the Doctor

 

• Pain passing urine.
• Pain with bowel movements.
• Problems passing urine.
• Problems having bowels movements.
• Excess or foul discharge from vagina.
• Pain, pressure, or itching in the vagina.

 

Phone Number

 

__________________________ Clinic: (608) ________________

 

After hours, weekends and holidays this connects to the message center.
Ask for the doctor on call for Dr. _____________________________________.
Leave your name and phone number with area code and the doctor will call you back.

 

Toll Free: 1-800-323-8942

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 03/29/2011

Copyright © 03/29/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5477

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