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Prolapse

Vaginal Pessaries for Prolapse

 

WHAT IS A PESSARY?

A device inserted into the vagina for the treatment of vaginal prolapse. It is usually ring shaped although various shapes are available.

WHEN IS IT USED?

It is a non-surgical option for the treatment of prolapse symptoms. It may be used instead of surgery or temporarily in patients where surgical treatment is delayed for any reason.

WILL IT WORK?

Not in everyone. You’ll need to try one to find out if it is going to work in you.

HOW IS IT INSERTED?

It is gently inserted via the vagina. In post-menopausal women it is best to use a vaginal oestrogen cream to reduce irritation from the pessary and even start using this a month prior to pessary insertion. At a fitting the health professional will determine the appropriate size. It is best if you empty you bladder and bowel before the fitting. To determine if the pessary is going to stay in the correct position you may be asked to bear down, cough, stand, or bounce up and down on your heels. Once the correct size is determined it is inserted or it may have to be ordered in, in which case you will need to return later for insertion.  This is  because there are a large number of different sizes and shapes to choose from.

WHAT PROBLEMS COULD I EXPERIENCE?

It is extremely important you return for regular visits to have the pessary removed and an examination to check for any problems from the pessary. If all is okay the pessary is cleaned, and reinserted. Usually after an initial visits at one week and one month, regular check ups are every three months to six months. These checks may be able to be done by your local doctor.  You can ask them if they are able to check the pessary for you.  You should continue to have your usual smear test as required by your local doctor. A small amount of white or yellow discharge is normal.

You will be asked to return in approximately one week to determine if you have had any problems.

You should contact the clinic if you develop any of the following:

• Difficulty passing urine

• Difficulty using the bowels

• Increased urinary incontinence or new incontinence

• Vaginal pressure, discomfort, heavy discharge, odor or bleeding

• Low back pain

Other rare complications include erosion or the vaginal wall or cervix, entrapment of the pessary requiring surgical removal, blockage of the tubes draining the kidneys to the bladder, trapping of bowel causing blockage or ischaemia, erosion into the bladder or bowel causing a fistula, (an opening between the vagina and the bladder or bowel).

DOES IT NEED TO BE REMOVED FOR INTERCOURSE?

This depends on they type of pessary used and you and your partners comfort.

Version: V3, July 2017

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