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Pessary Fitting

Pessary Fitting

What is a Pessary?

A pessary is a medical device that fits into the vagina to help support the uterus or bladder and rectum. It is a firm ring similar to the outer ring of a diaphragm that functions to reduce urine leakage by pressing against the vaginal and urethral walls. As a pessary is made of silicon rubber, it does not absorb any secretions or odors. Pessaries are available in different sizes and are sized based on the anatomy and individual needs of the patient so that it will not be noticeable by the patient. With continuous use of a pessary, you may feel a sensation of pressure or rubbing. If you observe any unusual bleeding or spotting, call your doctor immediately. Also, there may be an increase in vaginal discharge or secretions with the use of pessary. It is necessary to have regular health check-up appointments to change the size or shape of the pessary, which is common after the initial fit or after continued pessary use.

When to use a Pessary?

A pessary can be used for non-surgical management of pelvic organ prolapse. Pelvic organ prolapse occurs in women when the pelvic floor organs shift from the normal position and bulges out against the walls of the vagina. When this condition occurs, you may feel a bulge coming out of the vaginal opening. The condition occurs due to weak or stretched pelvic muscles resulting from childbirth or surgery. A vaginal pessary is designed to support the areas of pelvic organ prolapse.

Insertion and Removal of a Pessary

Pessaries should be removed from the vagina for regular cleaning to reduce the risk of complications. Follow your doctor's instructions for cleaning your specific pessary.

Some women may remove the pessary just before bed time and wear it again in the morning.

Steps to follow while inserting the pessary:

  • Make sure you wash your hands before inserting a pessary
  • Flexible points of a pessary are the openings in the ring-with-support and the notches inside the open ring. The pessary is half-folded by holding it halfway between the flexible points such that the curled part should be facing towards the roof. On the insertion edge of the pessary, apply a small amount of water-soluble soothing agent such as KY jelly.
  • Insert the pessary into the vagina smoothly as far as it enters by holding the pessary in either of your hands. The pessary can be inserted while crouching or standing with foot support or sitting with feet propped up.

Steps to follow while removing the pessary:

  • Wash your hands.
  • Locate the pessary rim right beneath the pubic bone at the front of the vagina by feeling the opening/notch and hook your finger under or over the rim.
  • Incline the pessary to some degree and slowly pull down and out of the vagina. Folding the pessary slightly will aid in easier removal.

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