Types of Pessaries
There are several types of pessaries, each designed for specific conditions and anatomical considerations: Ring Pessary: Often used for mild prolapse and stress urinary incontinence.
Gellhorn Pessary: Typically used for more advanced prolapse.
Cube Pessary: Suitable for severe prolapse where other types might not stay in place.
Donut Pessary: Used for more significant prolapse and is easier to insert and remove.
Indications for Use
Pessaries are primarily used for conditions such as: Pelvic organ prolapse: This includes
cystocele (bladder prolapse),
rectocele (rectum prolapse), and uterine prolapse.
Urinary incontinence: Specifically, stress urinary incontinence where physical movement or activity causes leakage.
Pelvic examination: To assess the type and degree of prolapse or incontinence.
Trial fitting: Different sizes and shapes are tried to find the most comfortable and effective option.
Instruction: Patients are instructed on how to insert, remove, and care for the pessary.
Benefits of Using a Pessary
Pessaries offer several benefits, including: Non-surgical option: Ideal for those who are not candidates for surgery or prefer to avoid it.
Symptom relief: Provides immediate relief from symptoms of prolapse and incontinence.
Customizable: Available in various shapes and sizes to fit individual needs.
Complications and Management
While generally safe, pessaries can have complications such as: Vaginal irritation or ulceration.
Infection: Regular cleaning and follow-ups are essential to prevent this.
Discomfort: If improperly fitted, a pessary can cause pain or discomfort.
Follow-Up and Care
Regular follow-up appointments are crucial for monitoring the condition and ensuring the pessary remains effective and comfortable. Patients are usually advised to: Remove and clean the pessary regularly.
Use vaginal estrogen creams if advised, to minimize irritation.
Report any discomfort or unusual symptoms to their healthcare provider immediately.
Conclusion
Pessaries provide an effective, non-surgical solution for managing pelvic organ prolapse and urinary incontinence. With proper fitting, care, and follow-up, they can significantly improve the quality of life for many women. It is essential to consult with a healthcare provider to determine the best type and size of pessary for your specific needs.
