A pessary is a removable vaginal device designed to support several types of pelvic organ prolapse (POP). It is a non-surgical, soft, flexible ring or cube inserted into the vagina. There are several different kinds of pessaries including support and space-occupying types that provide support to the vaginal walls and pelvic organs. Pessaries have been shown to decrease symptoms associated with POP and are often recommended as initial treatment or as an alternative to surgery. For the best individual outcomes, several types and sizes of pessaries, fitted by a health care professional, should be evaluated. A woman must also be able to manage her pessary.
Before suggesting a patient try a pessary the clinician should be aware of the some of the predictors of successful and unsuccessful pessary fitting. Pessaries, Pelvic Organ Prolapse and Physical Therapy is a free access professional literature review that examines how treating POP with pessaries can be most efficient and effective for patients and clinicians. It discusses the impact of pessary use on symptoms of POP, what makes pessaries more successful in some patients than others, how pessary use compares to other common treatments such as pelvic floor muscle training and surgery, and what training is recommended for clinicians to be able to fit pessaries. Based on the literature that was included in this review, pessaries should be considered as a first form of treatment for POP.
This literature review and blog was developed with Kimberly Rudeen, SPT, University of WA, Dept of Rehabilitation, Division of Physical Therapy as a component of an independent study project.
If you are a pelvic health therapist interested in continuing education regarding pelvic organ prolapse, please see my Teaching page.