Pelvic organ prolapse and incontinence pessary service
What is a pessary?
A pessary is a device that goes inside the vagina to help support a prolapse of the uterus (womb), bladder and/or rectum (bottom of the bowel). A pessary could also be considered to help with incontinence. A prolapse and/or incontinence can be caused by childbirth, the accumulative effect of heavy lifting, having a chronic cough and/or straining on the toilet or alternatively due to the aging process. Symptoms you may experience are a feeling of heaviness or bulging around the vagina/ incontinence, frequency and/or the inability to evacuate the bowels effectively.
A pessary is a conservative, low risk measure to help support the prolapse and can enable you to continue chosen activities which may typically worsen a prolapse. It may be necessary to wear the pessary all the time or a self-management approach can be adopted. On your initial assessment your women’s health physiotherapist will help determine what the best course of action for you will be.
Fitting of the pessary
There are several types of pessaries and during your consultation your women’s health physiotherapist will show you the options of which pessaries are appropriate for you. The pessary will be fitted on the day, it is not unusual to try more than one pessary before we get the correct size that suits.
After the first fitting, it is a requirement that you attend the clinic again in 2 weeks’ time to have the pessary checked. If all OK on that assessment, then you need to be routinely checked by our clinic every 3-6 months. Sometimes a different size or shape of pessary will have to be fitted, as things may improve or change over time.
What are the side effects?
Side effects of using a pessary under the correct instructions, with the correct follow up are very low. You will be shown how to remove the pessary if you are experiencing any problems. You may experience more vaginal discharge than normal, which may develop an odour. Vaginal irritation is another possible side effect. Women who are post menopause may need to use oestrogen cream (this should be prescribed by a GP and used for 2-4 weeks prior to attending the appointment).
If you have an offensive vaginal odour, copious amounts of discharge or unexplained pain or bleeding, you should immediately remove the pessary and contact your health care provider.
What else should I know?
You will be asked to pass urine before you leave the clinic, so be sure not to have just been to the toilet prior to attending
What does your pessary package include?
- 1 x initial 15 minute ‘virtual assessment’ with your women’s health physiotherapist
- 1 x face to face fitting appointment (approx. 45 minutes in total)
- A full prolapse/and or incontinence assessment
- Pessary fitting
- Self practice of removal of pessary
- 1 x silicone pessary to take home on the day
- A guide to the use and care of your silicone pessary
- Your follow-up appointment 2 weeks after fitting (up-to 30 mins)
Close contact time will be kept at approx. 15 minutes and social distancing will be maintained where able. Full PPE will be worn by the therapist.
A letter will be written to you GP or specialist explaining the fitting and ongoing management plan.
Appointments with our senior specialist women’s health physiotherapist and pessary fitting specialist, Deborah Schofield, can be booked online. Please email firstname.lastname@example.org with any questions prior to assessment.