Understanding using a Pessary for Pelvic Organ Prolapse

What Is a Pessary, and Could One Help You?

If you've been diagnosed with pelvic organ prolapse, your physiotherapist or gynaecologist may have mentioned a pessary as an option. Here's what they are, how they work, and what to expect - and how to care for your pessary.

What is a pessary?

A pessary is a small, medical-grade silicone device that's inserted into the vagina to provide internal support to the pelvic organs much like a supportive brace. It sits inside the vagina, supporting the bladder, bowel, or uterus and helping to reduce the symptoms of prolapse, such as heaviness, dragging, or bulging.

Pessaries have been used for centuries in various forms, but modern silicone pessaries are comfortable, durable, and available in a range of shapes and sizes.

There isn't a 'one-size-fits-all' pessary - fitting is individualised. Common types of pessary include:

• Ring pessaries - a simple ring shape, often a good starting point for mild to moderate prolapse
• Ring with support/knob - adds extra support, useful for certain types of prolapse
• Gellhorn pessaries - designed for more significant prolapse, with a stem and a supportive disc
• Cube pessaries - create suction to hold their position, useful in specific cases including more severe prolapse

The right choice of pessary depends on your anatomy, the type and severity of prolapse, your activity level, and your preferences.

Who might benefit from a pessary?

Pessaries can be a great option for people who:

• Want to avoid or delay surgery
• Are still planning future pregnancies
• Want extra support during exercise or heavy lifting
• Aren't good surgical candidates
• Simply want a non-surgical way to manage symptoms

What does fitting a pessary involve?

Fitting a pessary is a personalised process - your practitioner will assess your prolapse and try different sizes (and sometimes shapes) to find the best fit: one that's comfortable, stays in place, and effectively supports the prolapse. You'll usually be asked to move around, cough, or bear down during the fitting to test it under everyday conditions.

Once your pessary is fitted, you'll be shown how to manage the pessary yourself, or arrange for it to be checked and changed regularly by your clinician.

It's not a life sentence

Many people are hesitant about pessaries, imagining a permanent, uncomfortable device. In reality, well-fitted pessaries are often barely noticeable day to day and can be combined with pelvic floor physiotherapy for the best results. Some people use them long-term; others use them temporarily while working on strength, or around specific activities like running or gym sessions.

Curious whether a pessary might help you?

Book a consultation with our pelvic health team to discuss your options.

Caring for Your Pessary: A Practical Guide

If you've recently been fitted with a pessary, you might have questions about day-to-day life with it. Here's a general guide though always follow the specific instructions from your fitting clinician, as advice can vary depending on your pessary type.

Self-management vs. clinic changes

Some people are taught to remove, clean, and reinsert their own pessary, others prefer (or need, depending on the pessary type or their own dexterity and comfort) to have it checked and changed by a clinician every few months. Both approaches are completely valid, and your physiotherapist can help you decide what suits you. 

General pessary care basics

If you're managing your pessary yourself:

• Wash your hands well before and after handling it
• Clean the pessary with mild, unscented soap and warm water
• Check it for any damage, cracking, or wear each time you remove it
• Store it in a clean, dry container between uses if you're not reinserting straight away.

What's normal, and what's not

Generally normal:

• A short adjustment period as you get used to the sensation
• Mild increase in vaginal discharge
• Awareness of the pessary for the first few days, which usually settles.

Worth contacting your clinician about:

• Pain, bleeding, or a bad odour
• The pessary falling out repeatedly
• Difficulty passing urine or emptying your bowel
• Any ulceration, irritation, or unusual discharge
• The pessary feels like it has shifted or you can no longer feel it where expected.

Regular check-ups matter

Even with good self-care, pessaries need periodic review by a clinician generally every few months, though this varies. Long-term use without checks can occasionally lead to irritation or, rarely, more significant tissue changes, so don't skip these appointments even if everything feels fine.

Living life with a pessary

Most people find that once they're used to it, a pessary fades into the background of daily life. Many continue exercising, working, and being intimate as normal a properly fitted pessary shouldn't get in the way of any of this. If it does, it's worth coming back in for a review, as a different size or shape may suit you better.

If you have questions about your pessary or you're due for a check, get in touch with our clinic team - we're happy to help.