5 min read

Pessary Fitting & Pelvic Organ Prolapse

Do you have a feeling of heaviness in your pelvic floor, or have been told by your doctor that you have a prolapse?

Pelvic organ prolapse occurs when the pelvic organs, such as the uterus, bladder, or rectum, descend and push against the vaginal walls due to weakened pelvic floor muscles. This can lead to discomfort, urinary incontinence, and can significantly impact your quality of life. While surgical interventions are available for some cases, pessary fitting offers a non-invasive and effective solution for managing pelvic organ prolapse.

Understanding Pessaries

A pessary is a medical device designed to support the pelvic organs and alleviate symptoms of pelvic organ prolapse. It is typically made of silicone or plastic and comes in various shapes and sizes, allowing for personalized fitting to suit individual needs. Pessaries are often considered a first-line treatment option, especially for folks who wish to avoid or delay surgery or for those who are not suitable candidates for surgical procedures. Gynecologists, medical doctors, and physiotherapists with a focus on pelvic health (also known as pelvic floor physiotherapists) can all fit pessaries.

How Pessaries Work

Examples of different types of pessaries

The primary goal of a pessary is to provide support to the pelvic organs and help maintain their proper position. When inserted into the vagina, the pessary works by exerting pressure against the vaginal walls and providing support to the weakened pelvic floor muscles. This prevents the organs from descending and reduces the symptoms associated with pelvic organ prolapse, such as pelvic pressure, urinary incontinence, and discomfort during intercourse.

Would I benefit from having a pessary?

Pessary fitting can be beneficial for individuals who are experiencing symptoms of pelvic organ prolapse or other related conditions. You may benefit from a pessary if you identify with any of the following…

  1. Individuals with pelvic organ prolapse: pessaries are primarily designed to provide support to the pelvic organs (such as the uterus, bladder, or rectum) when they descend and push against the vaginal walls due to weakened pelvic floor muscles. Individuals with various degrees of pelvic organ prolapse can benefit from pessaries to alleviate symptoms and improve their quality of life.
  2. Pregnant people may experience pelvic organ prolapse or stress urinary incontinence due to the increased pressure on the pelvic floor. Pessaries can provide support and relief during pregnancy, and they are typically safe to use during this time.
  3. Previous pregnancies OR planning for future pregnancies: speak with your pelvic floor physiotherapist to see if you would be a good candidate for a pessary fitting to support your pelvic organs.
  4. Those seeking a non-permanent solution: pessaries offer flexibility and can be easily removed or changed as needed. When working with a pelvic floor physiotherapist, you may work on exercises and modalities to strengthen your pelvic floor in conjunction with the pessary. If you prefer to have control over your treatment and want a non-permanent solution, you may benefit from pessary fitting.

The Fitting Process & What to Expect During Your Appointment

Pessary fitting is a specialized procedure that should be performed by a trained healthcare professional, usually a pelvic floor physiotherapist or gynecologist. The process involves the following steps:

  1. Consultation: your healthcare provider (pelvic floor physiotherapist, medical doctor, or gynecologist) will review your medical history, conduct a pelvic exam, and possibly request imaging tests such as an ultrasound. This helps the healthcare provider assess the severity of the pelvic organ prolapse and determine the most suitable type and size of the pessary.
  2. Selection of Pessary: based on the examination, your healthcare provider will select a pessary that matches your anatomy and degree of prolapse. Pessaries come in various shapes, such as ring, donut, Gellhorn, cube, or inflatable types, and can be fitted with or without supporting knobs or arms.
  3. Fitting Process: at CAYA, your healthcare provider will use a trauma-informed approach and create a safe, warm environment during your appointment. They will explain every step of the procedure and will inform you that they can stop the examination at any point if you feel uncomfortable or distressed. They will communicate with you during the entire appointment and ensure you are feeling comfortable. Some pessaries are designed to be self-inserted, while others may require assistance from a healthcare professional.
  4. Adjustment: once the pessary is in place, your healthcare provider will ensure that it fits comfortably and provides adequate support without causing any discomfort. It may take some trial and error to find the right pessary that fits and suits your needs. You will need to make a follow-up appointment to ensure the pessary is fitted properly and comfortably.

Benefits of Pessary Fitting

Pessaries provide a less invasive alternative to surgery, making them a great option for those who want to avoid surgical interventions. Pessaries come in various shapes and sizes, allowing for personalized fitting to accommodate individual anatomical variations and preferences. They are also reversible and removable, and the treatment can be discontinued at any time without any permanent impact. Pessaries can also greatly improve quality of life and comfort by effectively managing the symptoms of pelvic organ prolapse.

If you are experiencing symptoms of pelvic organ prolapse, book an appointment with one of our medical doctors or pelvic floor physiotherapists to explore the treatment options that best suit your needs. It’s important to note that each person’s circumstances are unique, and pessary fitting may not be suitable for everyone. If you have questions about pessary fitting, please email us at info@cayahealthcentre.com or book an Initial Pessary Fitting Consultation with our registered pelvic floor physiotherapist Sarah Leong at https://cayahealthcentre.janeapp.com/#/staff_member/17/treatment/46.

We look forward to seeing you soon!