Treatments & Procedures - Non-surgical

Pessary

Last updated: November 1, 2005

Overview |
Medications |
Considerations |
Effectiveness |
Risk |
Urgency
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Overview

Vaginal prolapse may be treated nonsurgically or surgically. Nonsurgical treatment involves using a pessary, placed inside the vagina to support the prolapsing portion of the vagina (click on figure 1 to see more examples). Any patient with prolapse may be a candidate for a pessary. Once it is determined that the patient would like to use a pessary, the patient returns on separate visit with a nurse practitioner or their urologist, and several different types and sizes of pessaries will be placed to determine which is the best fit. Once the correct size and type are identified, the pessary is ordered. About 2 weeks later, when the pessary arrives in the office, the patient will return and be taught how to insert and remove the pessary. Pessaries may be worn for up to one week without changing them. It is usually recommended that they be used with an estrogen cream, and that the patient return for followup at routine intervals.

Medications

None

Considerations

Any woman with vaginal prolapse can be considered for pessary placement. Some woman may want to try a pessary while waiting for surgery. Others may want to use the pessary indefinately. Women who have arthritis may have difficulty placing and removing the pessary

Effectiveness

Pessary placement is very effective, but does not treat the prolapse. Using a pessary simply allows patients to function with a vaginal prolapse.

Risk

What are the risks involved with this procedure?

Women who use a pessary can develop vaginal sores inside the vagina from pressure points the pessary has created. However, if women use estrogen cream and follow up closely with their physcian, these sore are usually mild and treated by removing the pessary until the vagina has healed.