What is a Pessary?
A pessary is a removable silicone device placed in the vagina to provide support for pelvic organ prolapse or to help manage stress urinary incontinence. With proper care, a pessary can be a comfortable and effective long-term management option.
Types of Pessaries
- Ring pessary: Most commonly used; may have a support shelf for additional bladder support
- Gellhorn pessary: Provides stronger support for more advanced prolapse
- Cube pessary: Used for severe prolapse when ring or Gellhorn pessaries are not adequate
- Incontinence pessary: Designed specifically to support the urethra
Daily Care
If You Self-Manage Your Pessary
Many women learn to remove, clean, and reinsert their pessary independently:
- Remove the pessary at bedtime or on a schedule recommended by your doctor
- Wash with mild soap and warm water
- Rinse thoroughly and allow to dry
- Reinsert in the morning or as directed
- Some women remove the pessary only once or twice per week
If Your Doctor Manages Your Pessary
- Regular follow-up appointments (typically every 3-6 months)
- Your doctor will remove, inspect, and clean the pessary
- The vaginal walls will be examined for any irritation or erosion
Vaginal Estrogen
Local vaginal estrogen is often recommended alongside pessary use, particularly for postmenopausal women. It helps maintain vaginal tissue health, reduces the risk of irritation and erosion, and improves comfort.
When to Contact Your Doctor
- Increased vaginal discharge with odor
- Vaginal bleeding not related to menstruation
- Pain or discomfort that does not resolve with repositioning
- Difficulty with urination or bowel movements
- The pessary falls out repeatedly
- Any concerns about fit or comfort
Important Reminders
- Sexual intercourse is possible with some types of pessaries (especially ring pessaries) in place
- Remove the pessary before intercourse if it is uncomfortable
- A pessary does not protect against sexually transmitted infections
- Regular follow-up is essential for long-term safe use
Illustrations courtesy of the International Urogynecological Association (IUGA) Patient Information Leaflets.