Please note: This information was as current as we could make it on the date given above. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.
An article on this topic is available in this issue of AFP.
How to Use a Pessary
What is a pessary?
A pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder or rectum.
The pessary is most often used for "prolapse" of the uterus. Prolapse means that your uterus droops or tends to "fall out" because it loses support after you give birth or have pelvic surgery. This problem is usually fixed with surgery, but you can also use a pessary to help keep the uterus in place.
A pessary can help if you have a "cystocele" (when your bladder droops down into your vagina) or if you have a "rectocele" (when your rectum sticks up into the bottom of your vagina).
A pessary can also help many women with stress urinary incontinence (the leaking of urine when you cough, strain or exercise). Pregnant women with incontinence can also use a pessary.
What kind of pessary will I use?
Your doctor will decide which type of pessary you should use depending on the problem you have. The pessary has to be fit just right. There are no tools that can tell what the right size is. The pessary is fit by trial and error. It usually takes a few tries to get the right one.
After the first fitting, you'll need to go back to the doctor's office to have the pessary rechecked. Your doctor will probably check the pessary in a few days. After that you will probably be checked every few months. Sometimes the size or shape of the pessary will have to be changed.
How do I care for my pessary?
It's important that you follow your doctor's instructions about caring for your pessary. Most pessaries can be worn for many days to weeks at a time before they have to be taken out and cleaned with ordinary soap and water. You should be sure to keep your check-up appointments and clean the pessary as your doctor tells you.
Does the pessary cause any side effects?
You may notice more vaginal discharge than normal. Your vaginal discharge may also develop an odor. Certain vaginal gels can help with these side effects. Your doctor may or may not have you douche as well.
Vaginal irritation is another possible side effect. Women who are past menopause may need to use estrogen cream for the irritation.
Can the pessary get lost or fall out?
The vagina is a closed tube. The pessary can't go anywhere else inside the body. The pessary can fall out of the vagina if you strain or lift something. This usually means that your pessary is too small. Check with your doctor if your pessary keeps falling out.
What else should I know?
Many pessaries can be worn during intercourse--your doctor will tell you if you can't. Be sure to tell your doctor promptly if you have any discomfort with the pessary or if you have trouble urinating or having a bowel movement.
This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your family doctor.
Visit familydoctor.org for information on this and many other health-related topics.
Copyright © 2000 by the American Academy of Family Physicians.
Permission is granted to print and photocopy this material for nonprofit educational uses. Written permission is required for all other uses, including electronic uses.
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