What is a "Pessary"? 

A vaginal pessary is a soft, removable device that goes in your vagina. It supports areas that are affected by pelvic organ prolapse (POP). This happens when the bladder, rectum, or uterus drops or bulges down toward the vagina.

A pessary can also help if you have stress incontinence, which causes you to leak urine when you cough, strain, or exercise. Women who have incontinence during pregnancy might find a pessary helpful, too.

There are many different styles of pessary. Your physiotherapist will trial several to ensure you are fit the most suitable type.

Effectiveness?

Several studies have evaluated the success of pessary fitting, with success rates ranging from 41% to 74%. Success rates of up to 62% have been reported in patients with stage III and IV prolapse, indicating that pessaries are an excellent option even in a population with advanced POP. Studies varied considerably in the definition of successful fitting with variable lengths of follow-up—from 1 week to 36 months. In one study, up to 53% of women continued pessary use 3 years after successful pessary fitting. Most protocols for pessary fitting were similar, with initial fitting using a ring pessary and transition to a space-occupying pessary if the ring pessary failed. On average, 2 to 3 fittings were required until the appropriate pessary was found.

Risk?

With proper pessary fit and medical management, there are very few instances of adverse effects.  Many women may notice some initial cramping that may last for the first 2-3 weeks while the body accommodates to this new internal device. Some may also notice an increase is vaginal discharge or very light spotting. There are some instances of more adverse complications arising from pessary use in the event of very poor management or neglect. Serious complications can be thwarted with appropriate fitting, local estrogen, and regular, careful follow-up.

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Prior to being fit with a pessary, your family physician will clear any potential medical or tissue complication to ensure healthy tissues and a positive outcome.