Has anyone suggested you try a vaginal pessary? Maybe for a prolapse uterus (womb) or prolapse bladder (cystocele)? Or an “oestrogen pessary” to help with vaginal dryness or discomfort.
Pessary: one word – lots of different meanings:
If you’re confused by the word “pessary”, you’re now officially excused. I googled it. It’s a crazy world out there. Same word can mean a multitude of things.
If you get offered a pessary (or already got one) quick check below to understand better what it might be for:
there are several types:
- for giving medication via the vagina
- to support the urethra (the bladder tube)
- for pelvic organ prolapse (POP)
Don’t read on if you are squeamish about gadgets and devices. Some people don’t want or need to know more. Rather come back in the future if you need to 🙂
Pessaries to give medication to the vagina tissues
A pessary can be a vehicle for giving medication via the vagina. Via the anus is usually (but not always) called a suppository. Even the vaginal ones can come in several different styles
- capsule/bullet shapes that you push inside (eg for treating Bacterial Vaginosis BV)
- with a long tail to pull them out after use (eg Prostin – a prostaglandin pessary used to induce labour)
- a tablet pushed to the top of the vagina with an applicator stick which dissolves over night (eg clotrimazole Canesten for treating thrush or Vagifem, Vagiflux for applying oestrogen to the vagina walls
- a contraceptive medicated sponge (or barrier creating cap)
Urethral (bladder tube) support pessary
These sit in the lower part of the vagina, fairly near the opening, to create mechanical uplift to help prevent stress urinary incontince. they can be
- soft and squidy stressball-type material (eg Contrelle)
- a firmer hollow tube (Contiform)
- more solid (Incostress, Efemia, Uresta)
I have written a full article about these types of pessaries:
Pessaries to support Pelvic Organ Prolapse
More commonly when we talk about someone having a pessary “fitted” it is as a non-surgical solution (short or long term) for Pelvic Organ Prolapse (POP). Pessaries for pelvic organ prolapse sit higher in the vagina. They support the uterus (womb)/cervix and/or the front vaginal wall.
The most commonly prescribed and fitted types are:
- a ring pessary
- ones that look like bulky tampons, sponges
- disc-shaped sieves (Falk)
- discs with short handles (Gelhorn and Shelf Pessaries)
- cubes (exactly as their name suggests).
For more information about pessaries for prolapse read here
If you didn’t know about all of these you are not alone! Please be assured that these internal devices are not scary (up close) or nearly as big as you think. And they can be LIFE CHANGING. Many many women get great support, comfort and return to their activities from the use of these nifty gadgets. If you need help do get in touch to learn more.
Clearer??
Questions??
Do ask questions below. Or contact our team at ProPelvic Physio for an in person or virtual consultation. We can brainstorm your personal needs and options with you.
Hello, I have a posterior prolapse and have recently tried a ring pessary to help with peeing as sometimes I need to wiggle to get all the pee out! I had it put in and it lasted 24 hours before I had to take it out due to leading occurring somewhere within me. I can’t say that 24 hours it helped me, any better or provide any support for the posterior collapsed wall. I spoke with the nurse who fitted the pessary and she subscribed me a oestrogen suppository for two weeks which I am using however what can I do as my prolapse feels as though it is a lot lower down and I’m not sure what can be done to help me. Ladies with a posterior prolapse where the back wall is falling into my vagina cavity, is there any help for them? And if so, are you still able to have a sexual relation relationship with your partner?