What is a Vaginal Pessary?
A pessary is a device placed into the vagina, to support the uterus and vaginal walls. It is a firm ring or a disc (sometimes could be another shape) that stretches the wall of the vagina and supports pelvic organs, (the bladder, lower bowel, womb and top of the vagina). A properly fitted pessary is not noticeable when it is in place.
Different types of pessaries are used, depending on the type and degree of prolapse.
In the Urogynaecology Department we use a range of different pessaries depending on the individual needs of each patient, the different types are;
- Ring pessary - a thick ring
- Ring pessary with support – a softer silicone ring with additional support in the centre
- Incontinence Ring – with additional support for the urethra (urine tube)
- Falk Pessary - A plastic device which gives extra support
- Shelf pessary - a hard plastic device used for patients needing extra support for their womb
- Gelhorn pessary - this is a softer round silicone device which can be used as an alternative to a shelf pessary for some patients
There are a variety of additional pessaries that may be used if required.
Consultation
The Doctor or a specialist nurse will examine you to see what size/type of pessary you need. This is done by internal examination of the vagina.
The pessary is then inserted and positioned.
You may be asked to walk around to check that you are comfortable. You may also be asked to go to the toilet and pass urine to check that the pessary is secure and has not affected your voiding (passing urine).
The pessary needs to be changed regularly
This is usually every 4 to 6 months. You can have your pessary changed either in the Urogynaecology Clinic by a nurse or a doctor or at your Doctor’s surgery. The place of appointment is decided depending on type of pessary, facilities available at your Doctor’s surgery, other symptoms that you may have and your preference.
You may wish to learn to take the pessary out and reinsert it by yourself. If so, we can teach you to do so. In that case we can still see you at regular interval (once year) or as and when required. We will be happy to make appropriate plans tailored to your needs. If you are interested in managing by yourself, please let the clinic staff know.
Why did my Doctor suggest a vaginal pessary for me?
Insertion of a vaginal ring pessary may be a suggested treatment for you due to number of reasons:
- Pessary is a one of the treatment option offered to all women as it is simple and conservative way to control prolapse. Your Doctor or nurse will discuss this with you with other options depending on the extent of prolapse.
- If you are not fit for major surgery to repair the prolapse
- If you decide not to undergo surgery
- If you prefer a conservative (non-surgical) treatment to control symptoms
- If you need a temporary measure while awaiting surgery
Once it is in place, you should not feel it. If there is any discomfort you may need a different size or type of pessary.
What are the possible side effects/risks of having a vaginal pessary?
Some patients may experience the following: -
- frothy blood stained discharge
If you have any of these side effects, please contact the Urogynaecology Department.
Vaginal erosion
Occasionally the pessary may rub the vaginal walls causing erosion or a breakdown of the skin. The ring will need to be removed for a period to allow healing to take place.
We usually advise either a hormone based cream or vaginal pessaries (small tablets to be inserted in to the vagina) to be used regularly to prevent this from happening. If you are unable to use the hormone cream, we will suggest a non-hormonal vaginal moisturiser instead.
Will my vaginal pessary fall out?
After insertion of the pessary, we will ask you to cough, bear down, sit up, stand up and walk around, to test that the pessary has been fitted securely.
If, when you go home, the pessary falls out, do not panic. Please contact the Urogynaecology Department to arrange another appointment. Sometimes we may have to try more than one size, or type, of pessary to find the one which suits you best.
Will the vaginal pessary interfere with my going to the toilet?
The pessary should make it easier for you to pass urine and empty your bladder more effectively. If you have any difficulties passing urine please contact the Urogynaecology Department.
You may experience more leakage soon after the insertion of pessary. This symptom usually settles in a week or two. You should contact Urogynaecology Department if you continue to experience leakage.
Generally, it does not affect your bowel movement. Initially you may experience pressure which settles in few days. It is better to ensure that you are not constipated by drinking plenty of fluids and taking a high fibre diet.
Will the vaginal pessary affect my sexual life?
It is possible to have sexual intercourse with the pessary in place, although your partner may feel the pessary. You may find a different position more comfortable.
If you have a shelf/or Gelhorn pessary it is not possible to have sexual intercourse, this is because of the shape of the pessary.
Some pessaries can be removed to have sexual intercourse. You can be taught how to do this. Talk to your Doctor or nurse if you wish to learn this.
Who will change the vaginal pessary?
You will have a regular appointment in the pessary clinic at the Urogynaecology Department. You can have pessaries changed at the surgery if Doctor or practice nurse is happy to change it. You may wish to learn to change it by yourself. We can teach you to remove and reinsert the pessary if you wish to do so.
Do I have to wash "down below" more often, now that I have a vaginal pessary?
You should carry on as normal. We advise, however, that you refresh yourself with warm water to keep clean especially following going to toilet.
If I have any worries or questions about my vaginal ring pessary what should I do?
Please contact Urogynaecology Department on 01604 545267.
Other information
Northampton General Hospital operates a smoke-free policy. This means that smoking is not allowed anywhere on the Trust site, this includes all buildings, grounds and car parks.
Leaflets, information, advice and support on giving up smoking and on nicotine replacement therapy are available from the Stop Smoking helpline on 0845 6013116, the free national helpline on 0300 123 1044, e-mail: smokefree@nhft.nhs.uk and pharmacies.
Car parking at Northampton General Hospital is extremely limited and it is essential to arrive early, allowing ample time for parking. Alternatively, you may find it more convenient to be dropped off and collected.
This information can be provided in other languages and formats upon request including Braille, audio cassette and CD. Please contact (01604) 523442 or the Patient Advice & Liaison Service (PALS) on (01604) 545784, email: ngh-tr.pals@nhs.net.
Last update: July 2020
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