Question

Female Reproductive System Disorders

How do vaginal support devices treat pelvic organ prolapse?

A Answers (3)

  • Vaginal support devices known as pessaries are sometimes used to treat severe pelvic organ prolapse where an organ is protruding into the vaginal canal. A pessary is a small, removable device that is inserted into the vagina to support the pelvic organ that is pressing through the vaginal wall. Pessaries come in a wide variety of shapes and sizes, and your doctor will work with you to find one that fits comfortably. Your doctor will show you how to insert and remove the pessary so you can take it out to clean it periodically. Keeping the pessary clean can help control the potential side effects of using a pessary, which include vaginal irritation and a foul-smelling discharge.

  • AKevin Windom, MD, Obstetrics & Gynecology, answered

    Pessaries are vaginal support devices that can help remedy problems with pelvic organ prolapse (POP). A pessary is a small rubber device that comes in numerous shapes and sizes and it is placed into the vagina to help remedy POP. Some are made for cystoceles (bladder bulging into the vagina), some are made for rectoceles (the rectum bulging into the vagina), and some are made for uterine prolapse. It is important for patient's to discuss alternatives to surgery when they are seeking medical attention for their POP. I often will talk to patients about the risks, the benefits, and the alternatives of surgical intervention, and will discuss the use of pessaries. It is important that a patient is able to place and remove the pessary on her own, otherwise the pessaries left in the vaginal area for long periods of time can cause erosions, ulcerations, and infections.

  • AJill Rabin, Obstetrics & Gynecology, answered
    Pelvic organ prolapse can be corrected by surgery. However, there are many mechanical devices available. A pessary may be inserted into the vagina to ensure support of the pelvic organs in cases of prolapse. Pessaries have been in existence since classical Greek and Roman times. Plastic material became available in the 1950s and today most pessaries are produced from sophisticated silicone and other materials. Today, pessaries are used mainly for problems of prolapse and incontinence when support is needed for weak tissues and organs. Over 20 different types of pessaries are in use today. They are available in a variety of shapes and sizes.

    A pessary is a very personal item, and if you choose to use one, you must be evaluated by a medical practitioner and then fitted for it individually in order for it to do its job effectively.

    The pessary works much like an internal girdle to support the bladder, vagina, uterus, and rectum. It is inserted into the vagina and it basically substitutes for the connective tissue and strong muscle that most of us were born with. It replaces the organs from a dropped or prolapsed position to a position higher in the abdominal cavity. It does this by pressing on the undersurface of the vaginal support muscle, known as the levator muscle. So it replaces the organs by pushing up into the abdominal cavity on the undersurface of the pelvic support muscle, the levator muscle.

    It is very important to clean the pessary periodically. You can do this for yourself every week, or even more often. Remove it, clean it, clean the vagina, and replace the pessary.

    Many women decide to use the pessary only for daytime use. Others see their practitioner, their gynecologist, or their family doctor every 2 to 3 months to have the pessary removed and cleaned. If that is performed, then the provider needs to also remember to do a vaginal cleaning or douche prior to replacing the pessary.

    There are antibacterial gels available to use with the pessary to decrease bacterial content. It is also very important to make sure that any erosion or irritation of the vagina is treated by your provider. This can occur from an improper pessary fit, or leaving the pessary in too long. Other side effects can include back pain, vaginal odor, bleeding, pain, urinary or stool retention.

    Pessaries must be properly fitted and cared for, which takes quite a bit of patience. If the pessary does not fit properly, over time it can be refit to a different type or size.
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