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A vaginal pessary is a removable device placed into the vagina. It
is designed to support areas of
pelvic organ prolapse.
A variety of pessaries are available, including the
ring, inflatable, doughnut, and Gellhorn.
Your doctor will fit your pessary to hold the pelvic
organs in position without causing discomfort. Pessaries come in different
sizes and should be fitted carefully. See a picture of how a
pessary should fit.
Pessaries can be used successfully to treat other gynecologic
conditions, such as a uterus that is in the wrong position.
Your pessary will be fitted at your doctor's office.
You may need to experiment with different kinds of pessaries to find one that
feels right for you. Your doctor will teach you how to remove,
clean, and reinsert the pessary on a regular schedule. If it is hard for you to remove and replace your
pessary, you can have it done regularly at your doctor's office.
Depending on your comfort level and the type of pessary, you may be able to leave the pessary in during sexual intercourse.
But you cannot insert a diaphragm (a round rubber device used as a barrier
method of birth control) while wearing a pessary. If you have not reached
menopause, you may want to discuss birth control with
Pessaries are used as a nonsurgical approach to the treatment of
pelvic organ prolapse.
Pessaries are also used when symptoms of pelvic organ prolapse are
mild or when childbearing is not complete. They can be used in women who have
other serious chronic health problems, such as heart or lung disease, that make
a surgical procedure more dangerous.
Pessaries are sometimes used to see what the effect of surgery for
pelvic organ prolapse will be on urinary symptoms. This is called a "pessary
test." If you have a problem with incontinence with a pessary inserted, a
separate surgery to fix the incontinence problem may be done at the same time
as a prolapse surgery.
Pessaries are sometimes used to treat uterine prolapse in
young women during pregnancy. In this instance, the pessary holds the uterus in
the correct position before it enlarges and becomes trapped in the vaginal
Pessaries do not cure pelvic organ prolapse but help manage and
slow the progression of prolapse. They add support to the vagina and increase
tightness of the tissues and muscles of the pelvis. Symptoms improve in many
women who use a pessary. And for some women, symptoms go away.
Possible complications from wearing a pessary include:
Complications can be minimized by having a pessary that fits
correctly and that does not put too much pressure on the wall of the vagina.
Your pessary should be checked frequently by your doctor until
both of you are satisfied with the fit.
In postmenopausal women, estrogen (cream, ring, or tablets) is
sometimes used with a pessary to help with irritation caused by the
Follow your doctor's instructions for cleaning your
pessary. Regular cleaning reduces the risk of complications. The
cleaning schedule is determined by the type of pelvic organ prolapse and the
specific brand of pessary.
Pessaries often are an effective tool for managing pelvic organ
prolapse without surgery. They may be the best choice if you are a young woman
who has not finished having children, if you have been told that surgery would
be risky for you, or if you do not wish to have surgery for other
Pessaries can be used after a
hysterectomy. Women with severe
prolapse following a hysterectomy may have difficulty keeping the pessary in
place. This is because the walls of the vagina
are no longer held in place by the uterus and cervix.
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Other Works Consulted
Gleason JL, et al. (2012). Pelvic organ prolapse. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 906–939. Philadelphia: Lippincott Williams and Wilkins.
Liang CC, et al. (2004). Pessary test to predict postoperative urinary incontinence in women undergoing hysterectomy for prolapse. Obstetrics and Gynecology, 104(4): 795–800.
Weber AM, Richter HE (2005). Pelvic organ prolapse. Obstetrics and Gynecology, 106(3): 615–634.
ByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family MedicineKathleen Romito, MD - Family MedicineMartin J. Gabica, MD - Family MedicineSpecialist Medical ReviewerFemi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Current as ofFebruary 25, 2016
Current as of:
February 25, 2016
Sarah Marshall, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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