Pessary insertion involves the use of a soft device that is usually made of silicone. It can be used to treat conditions like genital prolapse or stress incontinence. Pessaries come in several different shapes and sizes, and the doctor will choose the one that best fits the patient’s needs.
What is Genital Prolapse?
Genital prolapse is a condition caused by a weakening of the pelvic floor or the muscles, ligaments, fascia and connective tissues that hold the pelvic organs in their proper place. Organs like the rectum, bladder or uterus then fall and press on the vagina.
In many cases, surgery can be performed to repair and strengthen the pelvic floor. But some patients either don’t want surgery, or they want to wait until they have finished having children. Our doctor can provide such women with a pessary to provide support to the vagina and keep the other organs in their proper place.
What Happens During a Pessary Insertion?
We will first perform a pelvic exam to determine the severity of the prolapse. We can then move forward with the pessary insertion. Size will be an important consideration. A pessary that is too small may simply fall out, while one that is too big will cause the patient discomfort. The patient shouldn’t feel the pessary at all.
Who is a Good Candidate?
Pessaries are for women who have either stress urinary incontinence or genital prolapse. In the latter case, we may offer a pessary if the patient can’t or doesn’t want to undergo surgery. The patient may, for instance, have a condition that makes having surgery dangerous. For such a patient, a simple pessary insertion is usually a safer option. The patient may also want to get a pessary if she is planning on getting pregnant in the near future.
The patient must understand that she will have to take care of the pessary. A patient unwilling to commit to such care is not a good candidate for a pessary.