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A Pessary is a medical device that is inserted into the vagina to support the pelvic organs due to prolapse or to help reduce stress urinary incontinence. Pessaries can help women more comfortable with sports, sexual activity (ring pessary), pregnancy (fit by an OBGYN) and can be used during peri-menopause, menopause, while awaiting surgery or after (once cleared from surgeon).
It can be made of silicone, rubber, or plastic, and comes in various shapes and sizes. If you have been prescribed a pessary, we will do a fitting to figure out which one works best for you.
Pessaries are able to help support the pelvic organs so that the pelvic floor muscles aren’t having to do all of the work alone.
Pelvic Organ Prolapse
Pessaries comfortably support pelvic organ prolapse in 66-95% of women who try to use one.
Supports the bladder neck
Pessaries may also support the bladder neck to help with stress urinary incontinence. Pessaries comfortably help with stress incontinence 33-50% of women who try one.
Everyone will use their pessary differently - whether for sports occasionally or everyday. The main reasons pessaries are prescribed and how they are used depends on the symptom severity, personal values, psychosocial circumstances, and the treatment goals that you have.
Pessaries are specifically given if someone has bothersome symptoms, they are interested in trying a pessary, they do not have any contraindications (see below) and they are able to manage the pessary follow up and care (specifically if self managing).
A pessary that works well will resolve your heaviness and/or bladder leaking symptoms. You should not feel the pessary, or feel a minimal supportive sensation. A pessary should not hurt once inserted. For most pessaries, you can insert and remove the pessary yourself, giving you the freedom to choose when you use it. Using a pessary to resolve your symptoms could help you avoid needing surgery.
At your pessary fitting appointment, the PT will assess your pelvic floor strength and any existing pelvic organ prolapse. The PT will do a general check of the inner and outer tissues of the vagina using a speculum. This is a general check - as a Physio, we cannot diagnose any tissue abnormalities which is why you get a formal letter and prescription signed by your MD/NP.
Please come with your bladder partially full.
If there are any concerns from your MD/NP, then pessary use will be delayed until appropriate treatment is received.
Learn about your pessary journey guide here.
Download the guideOnce you are fitted with your pessary, we will follow up at 1-2 weeks to ensure that the pessary is working well for you and to check for any vaginal tissue irritation. After this, we will follow up at 3 months and 6 months post-fitting. Finally, we will maintain a follow-up schedule of every 3-12 months depending on the pessary you have and if you are self-managing.
If you cannot keep these appointments, it is not recommended that you use a pessary.
Your follow up appointments can be done with either your fitting physiotherapist or your medical doctor.
I am available to see patients at any of the locations below. The wonderful part of physiotherapy is that it can be effective when you are in-person or virtually! I have had patients who have done well with their pelvic health journeys from the comfort of their home - making this a wonderful option for providing care. This means you get to choose what works best for you, based off of your comfort and circumstances :)
It is important to include the option of pessary use to patients as part of informed consent so each patient can decide what they feel will work best for themselves and their lifestyle. Pessaries can help anyone experiencing stress urinary incontinence (in general or with a specific activity or movement) or anyone who is experiencing a pelvic organ prolapse.
Pessaries have also helped women who do more resistance training and experience heaviness through the pelvic floor. They can be used temporarily while a patient awaits a surgery or while they complete a more symptomatic activity, or the patient can choose to wear it daily.
If you are not sure if a patient may benefit, you can always refer them for a discovery call where we can discuss further.
Learn about your pessary journey guide here.
Download the guideNot sure if I am a good fit for you? Or maybe you have more questions for me?
Message me and we can chat about how I can help you optimize your pelvis and sexual health!
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