A pessary is most often used when a prolapse of the uterus occurs. A prolapse means that your uterus droops or tends to sag because it has lost its natural strength or support after giving birth or after having pelvic surgery. This issue can normally be fixed with surgery, but if that is not an option, or you are waiting for your operation you can use a pessary for a prolapse to help keep your uterus in place.
What is a Pessary?
A pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder or rectum.
Pessaries come in a range of shapes and sizes to suit each woman’s individual needs. A pessary ring can help if you have a cystocele or rectocele. A cystocele is the medical term for when your bladder droops down into your vagina or while a rectocele is when your rectum sticks up into the bottom of your vagina. Pessaries can also help many women who are suffering from stress urinary incontinence. This is when you might leak urine when you cough, strain or exercise.
Pregnant women with incontinence can also use a pessary. If you are unsure which pessary ring you require then your doctor will be able to assess and advise you as to which is the best type of pessary you should use depending on the problem you have. Thanks to vast selection of pessary designs and sizes we have at Digitimer you can be sure to find one that fits perfectly.
Once it has been decided which type of pessary is right for you then you will need to go back to see your doctor, so they can check that it is working correctly and that you are using the right shape and size pessary ring. This visit will normally occur a few days after your first fitting. Following that, you will not need to visit the doctor again for a check-up for another few months. However, it is important you continue to go to these regular check-ups in case you need to change the shape of your pessary.
Pessary Ring Sizing Kits
The Pessary Ring Sizing Kits each consist of 4 rings made out of flexible high grade silicone. In contrast to the normal ring pessaries the rings in the sizing kit do not contain the elastic steel spring and are designed exclusively to gauge the correct size of pessary that you or your patient require.
Cerclage Pessary Perforated
This Cerclage pessary is used to treat pregnant women with cervical incompetence in order to support the cervix and turn it towards the sacrum. It may be indicated in pregnancies with a history of premature labour, multiple pregnancies or mothers who are exposed to physical strain (e.g. standing for a long time). It may also be indicated in pregnant women suffering from prolapse of the genital organs.
Cerclage Pessary Non Perforated
This Cerclage pessary is used to treat pregnant women with cervical incompetence in order to support the cervix and turn it towards the sacrum. Using transvaginal sonography in recumbent or upright position we have established normal values for the cervical length and an opening of the cervical os (funnelling) for singleton and twin pregnancies.
The silicone ring pessary contains a steel spring filling to keep its shape and may be used in patients with complaints of mild genital prolapse or urinary incontinence. The pelvic floor serves as support for the pessary. The ring pessaries may prevent milder forms of stress incontinence. The pessary can be inserted and removed by the patient herself.
Thick Ring Pessary
This thick ring pessary may be used in elderly patients with complaints of prolapse with or without incontinence. The thick ring pessary has a larger surface area and therefore the risk of local necrosis is reduced. The pelvic floor serves as support for the pessary. The pessary can be inserted and removed by the patient herself.
Cube Pessary Perforated
The Cube pessary is indicated in patients with more severe complaints of prolapse of the vagina and/o uterus for whom the pelvic floor is too weak to support ring pessaries. The vacuum effect of the concave surface permits adhesion so that this pessary can be used in cases with severe prolapse and incompetence of the pelvic floor.
Cube Pessary Non-Perforated
The non-perforated cube pessary is indicated in patients with more severe complaints of prolapse of the vagina and/or uterus for whom the pelvic floor is too weak to support ring pessaries. The vacuum effect of the concave surface permits adhesion so that this pessary can be used in cases with severe prolapse and incompetence of the pelvic floor.
Vaginal dilators are indicated in patients to expand the vagina for such indications as malformations, obstructions due to scars, after episiotomies or vaginal operations. The vaginal dilator consists of flexible silicone. Like all silicone pessaries they are elastic and can thus be inserted without pain. These particular vaginal dilators are of high quality and ensure that vaginal dilation is as comfortable as possible.
The urethra pessary may be used in patients with stress incontinence or a mixed form of urge and stress incontinence with previous surgery. The pelvic floor serves as support for the pessary. The pessary consists of a spring filling to keep its shape, surrounded by silicone. The thickening elevates the urethra and the transition of bladder and urethra so that an opening of the upper urethra is prevented.
This Bowl pessary may be used in patients with complaints of less severe prolapse. The pelvic floor serves as support for the pessary. Bowl pessaries are available in a perforated version.
Sieve Bowl Pessary
Bowl pessaries may be used in patients with complaints of less severe prolapse. The pelvic floor serves as support for the pessary. Bowl pessaries are available in a perforated version which is called a Sieve Bowl pessary which may facilitate the drainage of discharge.
The Hodge pessary is only used in cases with stress incontinence if ring pessaries are not tolerated because of anatomical aberrations, frequently caused by previous surgery. The Hodge pessary was introduced as a stiff ring pessary bent in two dimensions. Hereby, the elevation of the retroflexed uterus was the primary goal, an indication which has lost its significance.
Also known as the Gellhorn pessary, the club pessary may be used in patients with severe prolapse of vagina and uterus in cases where conventional pessaries do not sustain the pressure and where a cube pessary might increase stress incontinence. The stem avoids gliding of the upper lying bowl. Before inserting the pessary in severe prolapse, the prolapsed organs have to be reposed.
Tandem Pessary (Perforated)
The tandem pessary is made of two cubes of flexible silicone coupled to each other. Patients with severe uterine or vaginal vault prolapse may be treated with this pessary. The tandem pessary may be considered when the vagina cannot retain a single cube pessary. The vacuum effect of the concave surface achieves a good adhesion.
The tandem pessary is made of two cubes of flexible silicone coupled to each other. Patients with severe uterine or vaginal vault prolapse may be treated with this pessary. The tandem pessary may be considered when the vagina cannot retain a single cube pessary. The vacuum effect of the concave surface achieves a good adhesion. In addition, the tandem pessary can be useful in case of stress incontinence when the lower cube takes on the supporting function and the upper cube permits the adhesion.
How do I Care for my Pessary?
It is important that you follow any instructions giving to you by your doctor when it comes to caring for your pessary. Most pessaries can be worn for many days to weeks at a time before they need to be taken out and cleaned using ordinary soap and water. You should pay close attention to any cleaning instructions from your doctor. A possible side effect from wearing a pessary is that more vaginal discharge than normal may occur. If this happens you should adjust your cleaning routine accordingly.
Any additional vaginal discharge caused by using a pessary ring may also develop an odour. Vaginal irritation is also a possible side effect, although certain vaginal gels can help to reduce such side effects. Women who are past the age when the menopause normally occurs may need to use oestrogen cream for the irritation. Your doctor may also ask you to douche.
The vagina is a closed tube, so you do not need to worry about losing it anywhere else inside the body. Your pessary can fall out if you strain or lift something, but this is usually an indication that the pessary you have been fitted with is too small. You should book an appointment with your doctor if your pessary keeps falling out.
Many of the pessaries for prolapse that we supply can still be worn during intercourse and if they cannot that is something that your doctor will advise you on. You should also make sure that you tell your doctor promptly if you have any discomfort with the pessary ring or if you have trouble urinating or having a bowel movement.
The Digitimer team can discretely advise on any of our pessary products. Get in touch by emailing us at firstname.lastname@example.org.