Pessary

What is a pessary?

A pessary is a device that is inserted into the vagina to support organs if a prolapse has occurred (your bladder drops down, for example) and/or treat urinary incontinence. There are various types of pessary and they come in different sizes. The device is usually made of silicone.

Who can fit a pessary?

In general, pessaries are fitted by gynecologists or, in some instances, by urologists or else physicians with a subspecialty in urogynecology. More and more nurses and physiotherapists are trained to install pessaries and look after certain complications. It is essential to obtain your pessary from a professional and not try to create your own using everyday objects or materials, because you may risk causing yourself serious injury and even kidney problems.

Who uses a pessary?

The main users are women with genital prolapse (dropping of the bladder, uterus, rectum or vaginal vault) or patients with weak bladders (urinary incontinence). Less frequently and in very specific cases, a pregnant woman may wear a pessary.

Women of all ages choose pessaries because they do not want to undergo surgery, their general health does not allow them to have an operation or, alternatively, to help them to feel more comfortable while awaiting surgery (waiting lists). Some users will need a pessary when they do certain physical exercises, for example.

Can I take care of matters myself?

Most users are able to carry out the care needed themselves. If they cannot, a CLSC or outpatient nurse can help.

What care is needed?

The pessary must be removed on a regular basis, washed using a mild soap and rinsed. It must then be reinserted using a special jelly that lubricates the vagina and contains products that slow the development of bacteria and therefore unpleasant odour. We recommend the use of a long-term water-based gel.

Your doctor/therapist or nurse will suggest how often you should take these care measures. It will usually be once a week; care can be carried out once month or sometimes at longer intervals. It is very important to keep to the frequency of care suggested.

Can I have sexual relations while wearing the pessary?

Many patients have sex while the pessary remains in their vagina; this is not dangerous. In other cases, too little space remains in the vagina once the pessary is in place. It must then be removed during sexual relations.

Pessaries are obviously not a method of contraception and provide no protection against sexually transmissible diseases. There is no scientific documentation leading us to believe that condoms are just as effective with a pessary in place. If you have sex with a new partner, it would be preferable to use a condom and remove the pessary.

If I use a pessary, what should I be worried about?

Generally speaking, pessary users will notice an increase in vaginal discharge (sometimes because they use too much jelly). Significant changes in discharge, such as strong odour, pus, blood or very thick white discharge (like cottage cheese) are signs that you should consult your nurse or doctor as soon as possible. You should be concerned if your pessary causes you pain, constipation or difficulty in urinating.

WHEN IN DOUBT: REMOVE THE PESSARY.

How much does a pessary cost?

Passaries are not covered by the government health plan (RAMQ). The cost varies from clinic to clinic, and is around $120. Pessaries last for several years.