Pessary treatment

Pessaries are mechanical devices used to improve symptoms in patients suffering from prolapse or stress incontinence. The type of pessary prescribed varies depending on the specific indication and clinical findings, and a range of sizes are available to fit the patient's individual body shape. Modern pessaries are made from silicone rubber, which is well tolerated and does not cause any allergies. Pessaries made from glass, porcelain, clay, hard plastic or rubber were once common but are generally no longer used.

In patients with conditions resulting in the weakening of the ligaments holding the uterus in place (lowering or prolapse of the bladder, uterus or vagina; urinary incontinence), pessaries are inserted into the vagina and support (hold up) the urethra, bladder and pelvic floor.

The pessary is an effective "emergency measure" capable of improving urinary incontinence as soon as it is inserted. It is essential that the right pessary is selected in the right size for the patient's symptoms and clinical findings. The pessary should also be easy to insert and remove, it should not cause any pain and it should not be able to fall out. We are on hand to advise you and select the right pessary for you during our pessary clinic. You will receive instructions on inserting and caring for your pessary during your appointment and we will subsequently monitor your use of the pessary.

Once you have received initial guidance, you will be able to insert your pessary into your vagina yourself at home with the help of an oestrogen cream. You can insert the pessary while lying down, sitting down or standing. You can also remove your pessary (usually every evening) and care for it by washing it under warm water yourself. Depending on your symptoms, the pessary can be worn all day long or can be inserted as and when necessary before exercising, e.g. before playing sport or going jogging, and removed again afterwards. The pessary can also be taken out before sexual intercourse. However, if it does not cause any pain during intercourse, you can also choose to leave it in your vagina. To make them easier to use, some pessaries have a small string on which you can pull to remove the pessary like you would a tampon.

A pessary can be used permanently or temporarily.

Patients who wear a pessary permanently for many years very quickly adopt a routine for using and caring for it. Caring for their pessary becomes part of their daily personal hygiene routine and soon feels like a normal aspect of their everyday life. We only prescribe long-term pessary treatment to patients who consent to this and who are motivated enough to wear a pessary for a long period of time. Regular monitoring by your registered gynaecologist and in our pessary clinic ensures that you do not experience any problems when using your pessary. The benefit of long-term pessary treatment is that surgery can be avoided provided the symptoms are sufficiently improved.


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