Pelvic Organ Prolapse & Pessary 101

What is pelvic organ prolapse and how can a pessary help?

Quick Facts

• A pessary is a removable device inserted into the vagina to avoid projections (‘downward pressure’) of internal pelvic organs.
  • Bladder, uterus, or rectum.
  • Can help with incontinence as well.
• Many types of pessary exist, and while available in several varieties (shapes/size/purpose), they are ‘fitted’ to each woman’s fit and needs.
• Pessaries are made from medical grade plastic, silicone or rubber.
• Can be used after a hysterectomy.

Ideal Candidate

• If you suffer from a pelvic organ prolapse, which is when a pelvic organ ‘drops’ out of its original place.
• Typically used in place of surgery or as a pre-surgery management strategy.
• Suitable option for women still planning on bearing children.

Possible Causes for Prolapse and Subsequent Pessary Benefit

• Pregnancy and/or difficulties during labour.
• Menopause and/or decrease in estrogen.
• Chronic constipation and/or chronic cough.
• Weakness in pelvic muscles.
• Smoking.

Treatment

• Hospitals typically have a long wait list for pessary fittings. Certain pelvic physiotherapists have received qualified training, and are helping to alleviate the wait-time and difficulties women face from pelvic organ prolapse.
• Surgery may be necessary, if pessary use fails to provide adequate support.
• Our physiotherapy clinic offers pessary fittings and devices, without the standard wait times (2-3 months) of local hospitals.
  • Pessary device: $85.84 + HST
  • Assessment/fitting: $75.00
  • Follow ups (1-2 weeks post insertion, and beyond as advised): $40.00

Effectiveness

• Pessary is not a cure but is a way to manage the progression of a prolapse.
• Symptoms can improve, or go away entirely; allowing women support, function, and a better quality of life!

References:

http://www.cfp.ca/content/53/3/424
https://www.healthline.com/health/pessary
https://www.healthlinkbc.ca/health-topics/tv1613
https://www.mdedge.com/obgyn/article/79135/pelvic-floor-dysfunction/pessaries-vaginal-prolapse-critical-factors-successful/page/0/1
https://www.ncbi.nlm.nih.gov/pubmed/27504918