Pessary Placement Treatment

Pelvic organ prolapse affects both males and females. It occurs due to slipping of one or more pelvic organs from the pelvis. This weakens the muscles and connective tissue of a pelvis. Pelvic floor muscles are the body parts, which can be extracted from the muscles and connective tissues. These muscles are mainly found at the base of a pelvis and their main function is to support pelvic organs that can be bowel, bladder, ureters etc. They are most important for sexual reproduction, pregnancy and childbirth for women. 

When these muscles get weakened into the pelvic cavity, then it leads to pelvic organ prolapse. This condition is not treated or diagnosed easily. Women experience many health issues during sex and pregnancy. It leads to sexual issues, change in urinary and bowel movements, lower back pain, pelvic pressure etc., in patients. This health condition becomes rare or severe when left untreated.

Its best treatment approach is pessary placement. It is a device which supports the pelvic organs when it gets attached with a vagina. This procedure is not only helpful for pelvic organ prolapse but also beneficial for stress continence in patients. Its other name is pessary fitting. 

Types of Pessaries

This medical device consists of different types. These are as follows:

1. Ring Pessary:

• This can be placed easily in patients with stress incontinence and pelvic organ prolapse in mild to moderate conditions but cannot be recommended for urinary incontinence. It is an O-shaped pessary and can be applicable for different versions. A healthcare provider can choose the best option for a patient’s condition treatment. 

2. Donut Pessary:

• It is recommended for cystocele, rectocele and uterine prolapse treatment in individuals. This device is donut-shaped and can be made from soft and medical-grade silicone. When it becomes odorous or discolored, then a healthcare provider should replace this pessary after 12 months. 

3. Gellhorn Pessary:

• When a patient is suffering from advanced pelvic organ prolapse, then this option is best for him or her. This device is disk-shaped and it is also known as space-filling pessary. It fills the shape to provide support in the upper vagina as a ring pessary. 

4. Shaatz Pessary:

• The uterine prolapse and cystocele are being managed in moderate to severe condition. It is a disk-shaped device but does not have a knob. This equipment is mostly recommended for women who find difficulty with ring pessary. 

5. Cube Pessary:

• When an urinary stress incontinence is mild in patients, then this device is suitable for them. It also manages third-degree uterine prolapse and can be useful during sexual intercourse. The shape of this medical device is cubical. It does not have drainage which can be removed and cleaned daily. 

6. Gehrung Pessary:

• It is a U-shaped device, which is recommended for the treatment of cystocele, rectocele, stress urinary incontinence and second or third degree uterine prolapse in patients. This pessary is extracted from a medical-grade silicone and must be removed before X-ray, MRI and ultrasound tests. 

How Pessary can be Fitted? 

A vaginal exam will be performed and some measurements will be taken so that a pessary is correctly fit into your pelvic organs. Depending on the exam and severity of the prolapse, then a pessary with the right type and size can be opted for patients. 

After that, a pessary is placed into the pelvis and the doctor makes the process more comfortable through lubricant or lidocaine. 

The working of a pessary can be checked when a doctor tells a patient to cough, sit and squat. They may also identify its place if an individual is asked to urinate.

Advantages

The benefits of this procedure are the following:

• It is generally inexpensive and can be used safely by a doctor. 
• This method is minimally invasive, which provides pain-relief in patients. 
• It does not require surgery and can be a long-term treatment for pelvic organ prolapse and stress incontinence. 

Why is Pessary Treatment Recommend to Patients?

A healthcare professional recommends a pessary for the treatment of certain health issues. These are as follows:

• Neonatal prolapse
• Bowel problems
• Urinary Incontinence
• Vaginal wind
• Pelvic organ prolapse

This device is not suitable for patients with severe prolapse. They must consult with their relevant doctor for its treatment. 

Risks and Complications

Pessary placement is a safe procedure but it leads to different complications. These are as follows:

• Pain and discomfort due to wrong fitness
• Vesicovaginal or rectovaginal fistula
• Trouble during sexual intercourse
• Infection in urinary tract
• Pessary incarceration
• Bleeding and discharge 

How to Care for Pessary? 

If a ring pessary is inserted in the pelvis, then it is easy to take care of it. A patient can remove this device gently and the hands must be washed with mild soap and water. 

Before reinserting, a pessary should be rinsed and dried completely. 

The regular follow-up visits are required for monitoring the pessary effectiveness in patients. A vagina will be examined by a provider which identifies that this medical device is in still working condition. 

An individual must consult with a healthcare provider for cleaning and checkups if he or she gets troubled in removing the pessary on their own.