This depends on the kind of pessary you are prescribed. Most vaginal pessaries can be left in for as long as four to six months or unless told otherwise by your healthcare provider. In comparison, a type of pessary used for women with advanced degrees of vaginal prolapse, called cube pessary, should be removed every night. This type of pessary works by exerting suction pressure over vaginal walls and may cause vaginal ulceration if left in for too long.
You can remove your ring pessary for cleaning purposes once a week or even nightly and put it back inside the vagina. You also need to follow up with your healthcare provider every few weeks initially. During each visit, the doctor will check your pessary’s placement and clean it. The doctor will also inspect the vaginal walls for any signs of bruising or injuries.
If the type of pessary does not allow for removal while at home, you will need follow-up visits every two to three months.
What are the benefits of using a pessary?
A vaginal pessary is a prosthetic device that is fitted inside the vagina and is typically made of silicone, which is a flexible material. This device holds the prolapsed organ in its place.
Women who do not want surgical repairs for problems, such as the cervix or uterine prolapse and stress urinary incontinence, significantly benefit from using a vaginal pessary. Organ prolapse, particularly cervical, vaginal or bladder, happens when the ligaments and muscles that hold the organ become weak and drop down into the vagina. Stress urinary incontinence is the leaking of urine when you cough, strain during bowel movements or exercise.
Pessaries can be used safely for long-term management of pelvic organ (for example, uterus) prolapse. Some women can comfortably wear the pessaries for years, whereas others may prefer to use them only during physical activities, such as jogging and moderate to high-intensity exercises.
How is a pessary fitted?
A healthcare provider will try to find the right size of pessary for your vagina. They may need to try a few before ensuring it fits properly. If the pessary is small, your vagina will not be able to hold it for long. If it is large, you may find it uncomfortable because it stretches the vagina.
Although the insertion of the pessary takes anywhere between 30 and 45 seconds, you may need to wait 15 to 20 minutes, during which, your healthcare provider will observe if you are feeling any discomfort by asking you to walk.
Does a pessary cause any complications?
A pessary is a foreign device and insertion of any foreign object can carry some risk. The possible complications of pessary include:
- Foul-smelling or white-colored discharge
- Irritation of the vagina
- Pain or discomfort during sexual intercourse
- Vaginal ulcerations
All these signs either indicate the pessary is not in place or the appropriate size for you.
A white discharge is common after the insertion of pessary. Your doctor will most likely prescribe you estrogen creams for local application to manage this.
You can continue to have sex with an inserted ring type of pessary. However, the insertion of other kinds of pessary, such as donut, cube and Gellhorn, must be removed before sex.
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Cleveland Clinic. Pessary. https://my.clevelandclinic.org/health/drugs/16036-pessaries
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