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Pessaries: What Are They and When Do You Use Them?

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Until surgical methods matured, pessaries were the only form of treating pelvic organ prolapse (POP), such as cystocele, rectocele, uterine prolapse and stress incontinence. A pessary is classically a round ring that is placed into the vagina to reduce the prolapse. It derives from the Greek word pesos, meaning stone. Modern pessaries can take many shapes: rings, cubes, horns, rings with knobs and semi-circle forms.

Since the lifetime risk for a woman in the U.S. for undergoing POP surgery is 11 percent, pessary is often discussed as one of the non-invasive treatment options either for mild-moderate prolapse or in women who may not be good surgical candidates.

Pessaries must be properly fit to the woman’s pelvis and must be comfortable. Often, two or three fittings are necessary in order to see which size is appropriate. Not many practitioners are skilled in fitting pessaries, but usually, a GYN nurse practitioner is the most common health care professional who does the fittings.

Care must be taken when using a pessary. Women who have them inserted must be comfortable removing and placing them by themselves. They must be removed before intercourse. Local estrogen cream is necessary to keep the vaginal tissue from becoming irritated from the pessary. It can be left in during the day and removed at night. Side effects include: discharge, odor, vaginal skin irritation with bleeding, spontaneous expulsion, obstructive urination and discomfort.

Rare cases of vaginal erosion or ulceration can occur if women forget they have a pessary in place. If the woman cannot remove it herself, she must at least visit her practitioner on a frequent basis to have it removed and cleaned.

Link to blog: http://femaleurologyaz.blogspot.com/2009/08/pessaries-what-are-they-and-when-do-you.html

Add a Comment12 Comments

EmpowHER Guest

I was wondering where I could get reliable information on the average age at which women tend to start using a pessary ?
Thank you.

March 2, 2011 - 6:59am
EmpowHER Guest

Bravo on the last post. It's amazing the arrogance and rudeness of some posters. It takes away from the topic at hand and it is clear the poster is more interested in pushing their own product or idea. It's nice to see a little class instead of a pseudo-knowledgeable derision of others' posts or thoughts.

December 27, 2009 - 1:45pm
EmpowHER Guest

Thanks Alison B- on all my other topic posts none of the other commentors have been "borderline" offensive. I always welcome comments on this blog or my own site- except when direct shots are fired. -Dr. K

August 10, 2009 - 7:59pm

The Moderators of this site have most likely deleted comments that are attacking and inflammatory, and we ask that all users provide personal experiences and health information that is insightful, respectful and empowering.

Differing opinions or research findings can be discussed in such a manner that provides the readers the ability to become more informed, knowledgeable and to create well-constructed and educated questions for their health care providers. There is a fine line in finding the appropriate professional writing techniques that lend themselves to healthy debates vs. telling someone else their "knowledge is limited" or their "comments are ridiculous".

Differing opinions can be discussed, and are welcome, in such a manner as not to attack, degrade or otherwise demean the other person.

August 9, 2009 - 9:17am

I guess since you deleted your last comment, I will delete my response.

August 7, 2009 - 7:52pm

Just empowering women, sir.

August 7, 2009 - 7:05am

Your surgeries and pessaries are not products?

August 7, 2009 - 6:32am
EmpowHER Guest
Anonymous (reply to Moonspinner)

I don't sell pessaries and my site is informational. Surgery, or any other medical recommendation cannot be given over the internet. For a professional opinion and personal time, an appointment can be made. On my site/blog I do not enocurage surgery or pessary use- just what is available and interesting to the public. What I DO NOT do is troll internet sites to leave my name and website so people can buy my books, exercise tools and videos.

August 7, 2009 - 6:53am

I am afraid it is your conventional view of pelvic anatomy that is woefully misconceived. There is no “pelvic floor”, but rather a wall of muscle at the back of the body - just like in quadrupeds. It is the strong lumbar curve that makes human bipedal posture possible. All of the pelvic organs are bi-axial, so that the bulk of their weight is carried toward the front of the body and away from the genital hiatus at the back of the body. Natural female posture keeps pelvic organs properly positioned. By age thirty or so, most women have lost natural spinal curvatures because they have spent their lives in spinal flexion - upholstered furniture, car seats, etc. By returning to natural posture the pelvic organs are slowly repositioned. An anti-inflammatory diet helps the process tremendously by correcting the nutritional matrix of connective tissue. The idea that there is a soft-tissue “hole” at the bottom of the body that “holds up” the organs and therefore must be “strengthened” through kegel exercise is being greatly debunked. Your pessary comments are ridiculous. Prolapse is epidemic in postpartum women and pessaries are utilized by women of all ages, along with the many organic vaginal balms available. Christine Kent, Whole Woman.

August 7, 2009 - 6:18am
EmpowHER Guest
Anonymous (reply to Moonspinner)

Thanks for your response- but my view is far from conventional AND I am not selling any products.

August 7, 2009 - 6:25am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.