Pessary And Prolapse

Pessary And Prolapse

By Ayush Henry

A vaginal pessary is an effective and removable device designed to manage pelvic organ prolapse without surgery. It is also used to treat stress urinary incontinence, retroverted uterus, cystocele and rectocele. Pessary may be the best choice for a young woman who:

  • Wants to have more children,
  • Do not want to undergo risky surgery, or
  • Do not wish to have surgery for other reasons.

Pessary And Prolapse

Pessary can be fit into the position without causing any discomfort. Pessaries can be used successfully to treat other gynaecologic conditions, like a uterus that is in the wrong position. There are variety of pessaries available that include shaatz, donut, and Gellhorn. It comes in different sizes and should be fitted carefully.

To find the best that feels right, you may have to experiment with different kind of pessaries available. Your doctor will guide you how to reinsert, remove and clean the pessary on regular schedule. If it is hard to remove and replace pessary, you can have it done regularly at your doctor's office.

Risks Involved

Risks involved while wearing a pessary include:

  • Bleeding.
  • Open sores in the vaginal wall.
  • Bulging of the rectum against the vaginal wall.
  • Wearing away of the vaginal wall. In severe cases, fistula can form between the vagina and the rectum.

These complications can be minimized by wearing the right size of pessary that does not exert too much pressure on the wall of vagina. Pessary must be checked frequently by your doctor for complete satisfaction with its fitting.

In postmenopausal women, cream or tablets are sometimes used to control irritation caused by pessary.

Regular cleaning reduces the risk of complications. The cleaning schedule is determined by the type of pelvic organ prolapse and the brand used. Follow your doctor's instructions for proper maintenance.

Pessary And Prolapse

 

Limitations of Pessary

Pelvic organ prolapse cannot be cured completely with pessaries but they can help manage and slow the progression of prolapse by supporting the vagina and increase the tightness of muscles of the pelvis. Symptoms improve in many women who use a pessary. For some women, it takes time for symptoms to show improvement.

Women who have undergone hysterectomy, a pessary may not be a good choice. This is because uterus and cervix are no longer able to hold the walls of the vagina in place. Women with severe prolapse following a hysterectomy may have trouble keeping the pessary in place.

Women may be able to leave the pessary in during sexual intercourse as per the comfort level and type of pessary used. But diaphragm (for birth control) cannot be inserted while wearing a pessary. You may need to consult with your doctor for the alternatives.

Pessary And Prolapse

Try EvaCare Folding Hodge Pessary Without Support which has wires that allow it to be manually shaped for different anatomies. It can be used for a first to second degree prolapse, cystocele, stress incontinence and an incompetent cervix or uterine retroversion. Because of the shapable wires, it must be removed during x-ray, ultrasound and MRI.

You can even look for EvaCare Flexible Oval Pessary With Support that performs the same function as the Ring pessary but it is designed specifically to fit a narrow vaginal vault. It is used to treat first to second degree prolapse and cystocele. The oval pessary works extremely well in women with a prior history of vaginal surgery, resulting in scarring and in some cases, palpable sutures from anterior repair or bladder suspension procedures.

For perfect fit and best result prefer consulting your doctor. In case of any irritation or bleeding keep the emergency contacts ready.