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.