Use of Pessaries – General Medical

THE USE OF PESSARIES

GENERAL INFORMATION

Pessaries are sometimes prescribed, fitted, and inserted in the vagina for various combinations of pelvic support problems.  Much of fitting a pessary to an individual patient involves trial and error, rechecking, and following up in the office.  There is also an element of maintenance that is required of the patients themselves.

General Instructions:

1. The pessary will be fitted by physician or practitioner at the office.  This can involve trying various types and sizes until the appropriate fit is obtained.

2. Follow up visit within a few days is required to watch for inappropriate fitting.

3. A second follow up is usually done within another short interval.

4. Thereafter, regular follow up on a six to eight week schedule is recommended to check, remove, clean, and replace the pessary.

5. Some patients choose to learn proper self-insertion.  Once the skills are achieved, office visits very four months are suggested.

Common Problems:  Discomfort, infection or discharge, and pessary expulsion (falling out).

Precautions:  Report any pain related to the pessary and come in immediately for evaluation (within 24 hours of onset of pain).  If the pessary is passed out of the vagina, it may be rinsed, put in a plastic bag, and brought back to the office for reevaluation.  Call and be seen if any change in bleeding or vaginal discharge or any other sign of infection.

Preventing infection:  There are various vaginal preparations that can be used to help rinse away discharge or accumulated bacteria related to a foreign body (pessary) in the vagina.  These can include occasional douching with vinegar and water or Betadine or the use of pH maintenance products such as Amino-Cerv, Trimo-San, etc.