Cassey Rivera, APRN, DNP, DNP-WHNP

A pessary is a device that is inserted into the vagina to relieve symptoms associated with mild to moderate pelvic organ prolapse, a condition in which the womb, bladder, or rectum bulges into the vaginal canal. This device is made of either rubber or plastic and is a safe, nonsurgical way to provide support for prolapsed organs.

Pessaries come in different shapes and sizes, and finding the right one can take some trial and error. Before a pessary fitting, patients will be examined and evaluated based on prolapse-related symptoms they may be experiencing, which may include discomfort, urine leakage when sneezing or coughing, and trouble keeping tampons in.

The following tips can help guide the process of finding the right fit:

• Once in place, patients should not be able to feel the device at all. If there is even slight pressure, patients should let their healthcare provider know, and she will find a pessary of a different size or shape.
• The pessary should not fall out with sneezing, coughing, jumping, or squatting. While getting fitted, patients should try jumping or squatting to see if the device will fall out. If it does, a different pessary will be inserted until they find one that stays in place.
• Patients and their healthcare providers should make sure the device is improving symptoms by having a check-up 5 to 15 days after it is inserted. If there is no improvement, patients may have to be re-fitted with a different pessary, or patients may be asked to consider surgical options.