What is a Pessary?

A pessary is a rubber device that fits into your vagina to help support your uterus (womb), vagina, bladder, or rectum.

The pessary is most often used to treat prolapse of the uterus.  Prolapse refers to when the uterus drops or “falls out” because it loses support after childbirth or pelvic surgery.  The problem can usually be fixed through surgery, but it is also possible to treat prolapse with a pessary.

A pessary can also help treat prolapse of the bladder (cystocele) and rectum (rectocele).

A pessary can also help many women with stress urinary incontinence (leaking urine when you cough, strain or exercise).  Wearing a pessary can also help pregnant women with incontinence.

Your doctor will decide which type of pessary you should use based on your particular condition.  The pessary has to be fit precisely; the right size can be determined only by trial and error. It usually takes a few tries to find the right fit.

A few days after the first fitting, you will need to go back to your doctor’s office to have the pessary checked. Afterwards, you will probably need to have it checked every couple months. Sometimes the size or shape of the pessary will have to be changed.

It is important that you follow your doctor’s instructions about caring for your pessary.  Most pessaries can be worn for many days to weeks at a time before they have to be taken out and cleaned. Pessaries can be cleaned with ordinary soap and water. 

You may be able to take out, clean, and reinsert your pessary yourself; or your doctor may want you to come into the office so he or she can do it for you.  Be sure to keep your check-up appointments and clean the pessary as your doctor tells you.

You may notice more vaginal discharge than normal.  Your vaginal discharge may also develop an odor.  Certain vaginal gels can help with these side effects.  Your doctor may or may not have you douche as well.

Vaginal irritation is another possible side effect.  Women who are past menopause may need to use estrogen cream for the irritation.

The vagina is a closed tube. The pessary cannot go anywhere else in the body.  The pessary can fall out of the vagina if you strain or lift something; this usually means that your pessary is too small.  Check with your doctor if your pessary keeps falling out.

Many pessaries can be worn during intercourse; your doctor will inform you if you cannot.  Be sure to tell your doctor promptly if you have any discomfort with the pessary or if you have trouble urinating or having a bowel movement.