What is a pessary?

• A pessary is a medical device designed to support pelvic organs or treat certain gynecological conditions, such as pelvic organ prolapse or urinary incontinence. It is a removable device that is inserted into the vagina to provide structural support to the pelvic organs, including the uterus, bladder, or rectum, when these organs have descended or shifted from their normal positions and are causing issues.
• Pessaries come in various shapes, sizes, and materials, and they are fitted individually based on a patient’s specific condition and anatomy to provide pelvic organ support and/or urinary incontinence management.

Follow up visits after you receive your pessary: 

• It’s important to note that pessary use requires regular follow-up visits with a healthcare provider to monitor the effectiveness, assess any potential complications (such as vaginal irritation or ulceration), and make necessary adjustments or replacements as needed.
• You will be asked to schedule a 6 month follow-up visit with us to assess the pessary effectiveness and address any concerns or adjustments needed.
  • At the follow-up visit, we will assess the fit of the pessary to ensure it is still providing adequate support and comfort, and that there has been no change to your anatomy that would require a different size or type.
• **We cannot stress enough that we HIGHLY encourage patients to schedule a yearly vaginal speculum exam with their primary care or OBGYN to have vaginal mucosa checked for any signs of irritation and to ensure the entire healthcare team is aware of a medical device in place.**
• Initial discomfort after placement
  • It is normal for some minor discomfort for ~1-2 weeks.
  • If you are feeling discomfort, take out the pessary for a day, then re-insert for a few hours the first day. Repeat each day, increasing the number of hours you wear it as you are able to without increasing discomfort.

Pelvic or Vaginal mesh surgery: 

• Empowered Physical Therapy does not perform pessary fittings for individuals with vaginal mesh implants or pelvic mesh devices. This policy is in place to prioritize patient safety and avoid potential complications or interactions between the pessary, skin, and mesh implants.

  Patients with vaginal mesh implants seeking treatment for pelvic organ prolapse or urinary incontinence are encouraged to discuss alternative treatment options with their healthcare provider.

Your pessary type: _________________________________

Pessary Maintenance and Cleaning: 

• Ring pessary: Self or provider-assisted removal every 2-4 months minimum.
  • Wash with unscented soap and water prior to re-insertion
  • Can be left in for intercourse if you are able and comfortable.
• Ring pessary with support membrane: Self removal every 2-4 weeks minimum.
  • Wash with unscented soap and water prior to re-insertion
  • The membrane was designed to allow for drainage, but may not fully allow passage of discharge or larger period clots. If you find your membrane is not properly draining, please remove more frequently as needed to prevent infection.
• Cube or Continence dish: Self removal daily. 
  • Wash with unscented soap and water
  • Leave out for the night, and re-insert the next day
• Discoloration of the pessary
  • Can be normal and is often not a cause for concern.
  • Can undergo slight changes in appearance due to exposure to vaginal fluids, lubricants, and natural body processes.
  • We recommend a water based lube for all pessary handling AND intercourse
  • Normal Wear and Tear: Like any medical device, pessaries can experience normal wear and tear over time, which may manifest as changes in appearance, including discoloration.
  • If you notice your pessary has developed cracks, please discontinue use and contact us for a replacement. 

Please contact us immediately if you have signs and symptoms of complications:

• vaginal discomfort or pain, abnormal constipation
• Call 911 immediately if you have abnormal vaginal discharge or abnormal bleeding.