What is Pessary?
The pessary is a temporary device made of soft and flexible material and inserted in the birth canal or vagina fro give support in case of organ prolapse. (organs prolapse or move downwards, including the uterus, rectum, and urinary bladder).
Types Of Pessaries:
Pessaries have been classified into various categories according to their purpose, size, and shape.
Ring-shaped pessary
A device in the form of a circle
Gehrung
A device of U shape is advised to be used in case of advanced uterus prolapse.
Cube
The type of pessary used in advanced stage organ prolapse to make the organ compact and inserted into the vagina. It has the advantage of extreme support.
Gellhorn
Type of pessary that is disk-shaped having a small knob to relieve mild to severe organ prolapse
Some other types of pessaries are:
Mar-land pessary.
Doughnut pessary.
Benefits OF Pessary
- 1. Treat uterine prolapse
- 2. Help with urinary incontinence
- 3. Beneficial for females dealing with pelvic floor disorders.
- 4. Women can wear it for weeks or even months
- 5. Easily cleanable
- 6. Reinsertion is possible
- 7. Can be removed easily for sexual activity
- 8. Minimally invasive
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Side Effects Of Pessary
- 1. Smelly vaginal discharge
- 2. Pinkish-coloured discharge (due to excessively fit pessary)
- 3. Irritation
- 4. Damage vaginal walls
- 5. Bleeding
- 6. Involuntary passage of urine while sneezing or cough
- 7. Difficulty and pain during sexual intercourse.
- 8. UTIs (Urinary tract infections)
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Complications
Pessaries rarely cause serious complications. Some include
- 1. Vesicovaginal fistula
- 2. Rectovaginal fistula
- 3. Erosion
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How To Use Pessary
For using a pessary, there needs to be a physical examination of the vagina done by the health care provider. This examination will allow the doctor to recommend the most suitable type of pessary for the woman. This is necessary as a loose pessary has the chance of falling off from its site of insertion during specific bowel movements, activity, or urination. On the other hand, a larger pessary exerts enormous pressure, thus creating discomfort. Hence, it is essential to have a proper examination so that a proper fit is advised. Women can insert pessary in vagina themselves following instructions:
- 1. Wash hands before and after using the pessary
- 2. Minute quantities of lubricant like KY Jelly at the site of insertion
- 3. Fold the pessary and insert it into the spread-out lips of the vagina
- 4. Gently insert the pessary inside the vagina to its farthest end
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Pessary Patient Instructions
- 1. It should be inserted so that it should not make you feel uncomfortable.
- 2. It should not fall spontaneously out.
- 3. It should not pose any difficulty in the bathroom.
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When To See A Doctor
The pessary is inserted if a woman has to insert fingers to push skin near the vagina for emptying the bladder or bowel movements. This is organ prolapse that can be treated using a pessary.
- 1. In case there is intense pain, itching, tightness, and irritation at the site of pessary insertion.
- 2. When there is extreme pink-coloured discharge
- 3. When there is unbearable foul discharge from the vagina
- 4. If it feels bent or unfit
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Frequently Asked Questions
How long does a pessary stay in?
A fortnight or weekly cleaning should be done by removing the pessary and reinserting it to maintain hygiene and prevent microbial infections.
Once a woman has a pessary inserted to improve organ prolapse condition, follow-ups are critical afterwards.
A pessary can remain inside for months to years.
Is it painful to insert pessary?
Pessary insertion into the vagina does not seem painful until it causes complications or discomfort.
Can you pee with a pessary?
A perfectly fitting pessary inserted into the vagina never interfere with urination. Therefore, urinating is allowed with a pessary.
What can I use instead of a pessary?
For treating organ prolapse, there are various surgical and non-surgical options.
Despite having surgery, kegel exercises and other lifestyle changes can be made instead of pessary.
How do I remove my pessary myself?
Measures for removing pessary
- 1. Wash hands nicely before removing the pessary.
- 2. Try to locate the rim of the pessary that is inserted into the vagina
- 3. Tilt the rim of the pessary with the help of the fingers and try to pull it gently out from the vagina.
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