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A pessary a non-surgical management option for pelvic organ prolapse. It is a device that is fitted for your vagina that when in place, serves to support the weakened tissue in the vagina.
Pessaries come in different shapes and sizes, but are mainly categorized into two types. Depending on the type prolapse, many times we can find a pessary that will work for you.
Pessaries are fitted after an examination of the vagina is performed to get the approximate dimensions of the vaginal vault. In addition, it is important to inspect the vagina for any lesions, erosions, or other breaks in the skin as this can lead to bleeding and infection. Afterwards, a series of pessaries of different sizes will be tried to ensures that you have a good fit. You will be asked to perform some activities in order to ensure proper fit and comfort such as walk around, bend down, and empty your bladder. In order to be a good fit, two criteria must be met.
Patients will vary with regards to the frequency they remove and clean their pessary. Some patients will choose to remove and their pessary on a daily basis, while others will leave the pessary in place until their next office visit for the physician to remove and clean. In addition, using a cream such as Trimo-san with your pessary will help maintain the vaginal tissues. In women who are in menopause, vaginal estrogen creams are often used as well to help with maintaining the vaginal tissues. Ultimately, you will need to follow-up with our office every 3-6 months to have the pessary cleaned and to evaluate the vagina for any signs of erosions. If you develop bleeding or infection earlier than your scheduled visit, please contact the office.
Pessaries are typically very safe with very few complications. This is especially the case in a pessary that is fitted properly. However, there are a few issues with pessaries that patients should be aware of.
In general, the recommendation is to remove the pessary prior to intercourse. Some patients are able to have intercourse with a ring type pessary in place, however your partner may feel the pessary as well. With the space-filling pessary, intercourse will not be possible with the pessary in place. Please let Dr. Kow know if you are sexually active if you are considering a pessary.
Most insurance policies will cover pessary. Our office will help you with obtaining prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier to determine the details regarding your coverage.