Patient Information Leaflet
Vaginal pessaries for the treatment of pelvic organ prolapse and urinary incontinence
Produced by: Department of Obstetrics & Gynaecology
Date: July 2010 This page is left intentionally blank
2 If you require this leaflet in another language, large print or another format, please contact the Quality Team, telephone 01983 534850, who will advise you.
What is a vaginal pessary? A vaginal pessary is a removable device placed into the vagina. It is designed to support areas of pelvic organ prolapse.
What the different types of vaginal pessaries? There are many different types of pessaries available, most of them are made of silicone. The ring, shelf, continence dish and gelhorn pessaries are the ones commonly used at St Mary’s. Your doctor will discuss your individual needs and decide which type of pessary is most appropriate for the type of problem that you have. This may vary depending upon whether you are pre or post-menopausal and whether you are sexually active.
Why are vaginal pessaries used? Pessaries are used as a nonsurgical approach to the treatment of pelvic organ prolapse. 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. Some times pessaries are used to relieve the symptoms of prolapse while women are waiting for surgery. They may be used to see what the effect of surgery for pelvic organ prolapse will be on urinary and prolapse symptoms. This is called a “pessary test.”
3 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. Some of the pessaries can be used to improve symptoms of urinary incontinence.
How is the pessary inserted? The pessary is easy to insert. It is inserted through the vagina and no anaesthetic is required. Your doctor can insert the pessary at your visit to the outpatient department. Sometimes a number of sizes need to be tried to find the right size for you as the wrong size may fall out. If this happens you can dispose of the pessary and contact the hospital for an appointment.
In some circumstances, you may need to be taught how to remove and insert the pessary yourself, but this will be discussed when deciding what is right for you.
4 Can the pessary get lost or fall out? The vagina is a closed tube. The pessary can’t go anywhere else inside the body. However, the pessary can fall out of the vagina if you strain too hard or lift something heavy. This usually means that your pessary is too small. Check with your doctor if your pessary keeps falling out.
How well do vaginal pessaries work? Pessaries do not cure pelvic organ prolapse but help manage and slow the progression of prolapse by adding support to the vagina and increasing 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.
5 Are there any risks with having a vaginal pessary? Very rarely the pessary causes pressure areas in the vagina. It is important that you see your doctor every six months to have the pessary changed and to check the vagina. Please tell your doctor if you notice any unusual bleeding. You may notice more vaginal discharge than normal with the vaginal pessary. Your vaginal discharge may also develop an odour. In post menopausal women, oestrogen (cream, ring, or tablets) is sometimes used with a pessary to help with irritation caused by the pessary.
If you have been doing pelvic floor exercises to strengthen the muscles in this area, it is quite safe to continue with a pessary in place.
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7 Valuables should not be brought into the hospital. If patients have to bring in valuable items they should ask a nurse to store them safely and request a receipt for the items. You may not be able to have the valuable items returned if the time of discharge from hospital is out of hours. We are sorry but the Trust cannot accept responsibility for loss or damage to items not given for safe keeping. You can get further information on all sorts of health issues at: http://www.nhs.uk/ For Health advice and out of hours GP service please call the NHS 111 service on: 111 We value your views on our service If you wish to comment on the care which you, your relative or friend has received, we will be pleased to hear from you. Please speak to the person in charge of the ward, clinic or service in the first instance or ask them to contact the Quality Team. If you wish to contact them directly, telephone on 01983 534850. Alternatively you may prefer to write to: Chief Executive Isle of Wight NHS Trust St. Mary’s Hospital Newport Isle Of Wight PO30 5TG You can also share any concerns you have about our services with the Care Quality Commission (CQC) on 03000 61 61 61 or at [email protected] All NHS sites are no smoking areas. If you would like help and advice to stop smoking please call: Freephone 0800 169 0 169 to talk to the NHS Smoking Helpline.
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