The following blog is taken from the PESSARY GUIDELINES. This is an information blog only and NOT a substitute for medical advice. Please get in touch with myself, your local pelvic floor physio trained in pessary management, your GP or Gynaecologist to discuss you individual symtpom’s.
I think it’s safe to say after almost 3 years of fitting pessaries…I’m the Pessary Fairy for Mid and South Canterbury.
If you have never seen or heard of a vaginal pessary you are probably looking at this picture with a slight WTF?!? expression on your face….let me explain these incredible devices that are truely life changing.
These blue (and yellow…my new fitting kits are yellow) magic little devices are support pessaries for vaginal prolapse and stress incontinence that are made from silicon. “Pessaries are considered to be a relatively safe method of managing pelvic organ prolapse without serious side effects (Atnip 2009; Hanson et al 2006; Vierhout 2004; Gorti et al 2009; Fernando et al 2006; Sitavarin et al 2009).” and “are a first-line management option for women with pelvic organ prolapse:
with symptomatic pelvic organ prolapse
who decline surgery
who are unfit for or awaiting surgery
who have failed surgery
who have not completed childbearing
who are pregnant or postpartum
who are of older age and with co-morbidities.”
In a nutshell, these nifty little things are scaffolding for the vagina and help support the vaginal walls/pelvic organs when prolapse is an issue. They can also reduce and sometimes stop urinary leakage, as well as helping recovery of the pelvic floor post labour to reduce future risks of prolapse. Our research into these beauties is wonderful…for some women we can even cure their prolapse! (Who are these women…we don’t know exactly, but I have had some great success stories!)
Now before you read this and think “yay a cure” there’s a bit more to these pessaries. Not ever women needs one or will benefit from one, and you need to look after them. The can be a fantastic option to manage symptoms for some women (see the bullet points above). And for some women, we can try all the sizes and shapes and nothing works.
If I think a patient would benefit from a pessary, or they have been referred by another physio/GP/gynaecologist I first need to do an initial assessment taking their full medical and pelvic history and completing a vaginal exam. It’s a bit more that just putting it in the vagina and away you go.
The blue and yellow pessaries above are my fitting kits. I have a range of different sizes and shapes of pessary and I need to find the perfect one for the patient. These kits allow me to trial different shapes and sizes, and check they fit well, you can laugh, cough, pee without discomfort or the pessary falling out. I’ll also get you to move around, try some exercise (harder exercises if you are wearing them to play sport) and once we get the right fit, you get a brand new white silicon pessary to take home. During the fitting appointment, I will teach you how to insert and remove your pessary, clean it and look after it. The blue pessaires I then clean and sterilise afterwards.
I will see you a few more times to check the pessary is working for you and then life goes on until it’s been 12 months (or sooner if you have any issues) and you come back in for you yearly pessary WOF.
Which one is the best for you? Like everything else in Woman’s Health it really does depend on the individual so a detailed assessment is needed. The change this can make to a woman’s life when they are dealing with prolapse and/or incontinence is worth the time and patience!