Pessary Placement

Pelvic Organ Prolapse (POP) is a medical condition through which many women go through. A pessary is majorly used as a treatment for POP, and at times is used for stress incontinence and certain gynecologic conditions. It is inserted into the vagina, and can be removed later.

Types

There are many types of pessaries. They are usually made of silicon or inert plastic, and are valuable in many shapes and sizes, and may be supportive or space occupying. The common types of support pessaries are ring, Smith and Gehrung. Space occupying pessaries include donut, cube and Gelhorn. A suitable pessary type is selected after considering the patient’s history, severity, symptoms, uterus, vagina size and sexual activities. The chosen pessary must be large enough to fit comfortably.

Placement

Before a pessary is inserted, the bladder must be emptied. The pessary is then fitted into the vagina, and the patient must determine if it is comfortable or not. Usually there are no complications associated with pessary placement, and the procedure is simple enough. The patient can do it herself once she gets familiar with it. Pessaries must be cleaned regularly.

It must be mentioned that pessaries are not a cure for pelvic organ prolapse. The only thing that is achieved after a pessary placement is that prolapse progression is slowed down. This happens because pessaries provide vagina with the necessary support, and tighten the pelvis muscles. Prolapse condition is improved in many women, and the symptoms disappear in some women.

Risks

There are certain risks associated with pessaries. The most common of these are:

  • Bleeding
  • The vagina wall may develop open sores or wear away
  • The rectum bulges against the vagina or an opening is formed between them

These risks are minimized if the pessary is chosen appropriately.

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