Pessaries

A pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder or rectum.
The pessary is most often used for “prolapse” of the uterus. Prolapse means that your uterus droops or tends to “fall out” because it loses support after you give birth or have pelvic surgery. This problem is usually fixed with surgery, but you can also use a pessary to help keep the uterus in place.

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Pessary Ring Sizing Kits
The Pessary Ring Sizing Kit’s each consist of 4 rings made out of flexible high grade silicone. In contrast to the normal ring pessaries the rings in the sizing kit do not contain the elastic steel spring and are designed exclusively to gauge the correct size of pessary that you or your patient require.

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Cerclage Pessary Perforated
This Cerclage pessary is used to treat pregnant women with cervical incompetence in order to support the cervix and turn it towards the sacrum. It may be indicated in pregnancies with a history of premature labour, multiple pregnancies or mothers who are exposed to physical strain (e.g. standing for a long time). It may also be indicated in pregnant women suffering from prolapse of the genital organs.

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Cerclage Pessary Non Perforated
This Cerclage pessary is used to treat pregnant women with cervical incompetence in order to support the cervix and turn it towards the sacrum. Using transvaginal sonography in recumbent or upright position we have established normal values for the cervical length and an opening of the cervical os (funnelling) for singleton and twin pregnancies.

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Ring Pessary
The silicone ring pessary contains a steel spring filling to keep its shape and may be used in patients with complaints of mild genital prolapse or urinary incontinence. The pelvic floor serves as support for the pessary. The ring pessaries may prevent milder forms of stress incontinence. The pessary can be inserted and removed by the patient herself.

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Thick Ring Pessary
This thick ring pessary may be used in elderly patients with complaints of prolapse with or without incontinence. The thick ring pessary has a larger surface area and therefore the risk of local necrosis is reduced. The pelvic floor serves as support for the pessary. The pessary can be inserted and removed by the patient herself.

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Cube Pessary Perforated
The cube pessary is indicated in patients with more severe complaints of prolapse of the vagina and/o uterus for whom the pelvic floor is too weak to support ring pessaries. The vacuum effect of the concave surface permits adhesion so that this pessary can be used in cases with severe prolapse and incompetence of the pelvic floor.

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Cube Pessary Non Perforated
The non perforated cube pessary is indicated in patients with more severe complaints of prolapse of the vagina and/or uterus for whom the pelvic floor is too weak to support ring pessaries. The vacuum effect of the concave surface permits adhesion so that this pessary can be used in cases with severe prolapse and incompetence of the pelvic floor.

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Vaginal Dilator
Vaginal dilators are indicated in patients to expand the vagina for such indications as malformations, obstructions due to scars, after episiotomies or vaginal operations. The vaginal dilator consists of flexible silicone. Like all silicone pessaries they are elastic and can thus be inserted without pain. These particular vaginal dilators are of high quality and ensure that vaginal dilation is as comfortable as possible.

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Urethra Pessary
The urethra pessary may be used in patients with stress incontinence or a mixed form of urge and stress incontinence with previous surgery. The pelvic floor serves as support for the pessary. The pessary consists of a spring filling to keep its shape, surrounded by silicone. The thickening elevates the urethra and the transition of bladder and urethra so that an opening of the upper urethra is prevented.

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Bowl Pessary
This Bowl pessary may be used in patients with complaints of less severe prolapse. The pelvic floor serves as support for the pessary. Bowl pessaries are available in a perforated version.

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Sieve Bowl Pessary
Bowl pessaries may be used in patients with complaints of less severe prolapse. The pelvic floor serves as support for the pessary. Bowl pessaries are available in a perforated version which is called a Sieve Bowl pessary which may facilitate the drainage of discharge.

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Hodge Pessary
The Hodge pessary is only used in cases with stress incontinence, if ring pessaries are not tolerated because of anatomical aberrations, frequently caused by previous surgery. The Hodge pessary was introduced as a stiff ring pessary bent in two dimensions. Hereby, the elevation of the retroflexed uterus was the primary goal, an indication which has lost its significance.

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Club Pessary
Also known as the Gellhorn pessary, the club pessary may be used in patients with severe prolapse of vagina and uterus in cases where conventional pessaries do not sustain the pressure and where a cube pessary might increase stress incontinence. The stem avoids gliding of the upper lying bowl. Before inserting the pessary in severe prolapse, the prolapsed organs have to be reposed.

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Tandem Pessary (Perforated)
The tandem pessary is made of two cubes of flexible silicone coupled to each other. Patients with severe uterine or vaginal vault prolapse may be treated with this pessary. The tandem pessary may be considered when the vagina cannot retain a single cube pessary. The vacuum effect of the concave surface achieves a good adhesion.

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Tandem Pessary
The tandem pessary is made of two cubes of flexible silicone coupled to each other. Patients with severe uterine or vaginal vault prolapse may be treated with this pessary. The tandem pessary may be considered when the vagina cannot retain a single cube pessary. The vacuum effect of the concave surface achieves a good adhesion. In addition, the tandem pessary can be useful in case of stress incontinence when the lower cube takes on the supporting function and the upper cube permits the adhesion.

 

What is a Pessary

A pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder or rectum.

The pessary is most often used for “prolapse” of the uterus. Prolapse means that your uterus droops or tends to “fall out” because it loses support after you give birth or have pelvic surgery. This problem is usually fixed with surgery, but you can also use a pessary to help keep the uterus in place.

A pessary can help if you have a “cystocele” (when your bladder droops down into your vagina) or if you have a “rectocele” (when your rectum sticks up into the bottom of your vagina). A pessary can also help many women with stress urinary incontinence (the leaking of urine when you cough, strain or exercise).

Pregnant women with incontinence can also use a pessary. What kind of pessary will I use? Your doctor will decide which type of pessary you should use depending on the problem you have. The pessary has to be fit just right. There are no tools that can tell what the right size is. The pessary is fit by trial and error.

It usually takes a few tries to get the right one. After the first fitting, you’ll need to go back to the doctor’s office to have the pessary rechecked. Your doctor will probably check the pessary in a few days. After that you will probably be checked every few months. Sometimes the size or shape of the pessary will have to be changed.

How do I Care for my Pessary?

It’s important that you follow your doctor’s instructions about caring for pessaries. Most pessaries can be worn for many days to weeks at a time before they have to be taken out and cleaned with ordinary soap and water. You should be sure to keep your check-up appointments and clean the pessary as your doctor tells you. Does the pessary cause any side effects? You may notice more vaginal discharge than normal.

Your vaginal discharge may also develop an odor. Certain vaginal gels can help with these side effects. Your doctor may or may not have you douche as well. Vaginal irritation is another possible side effect. Women who are past menopause may need to use estrogen cream for the irritation. Can the pessary get lost or fall out? The vagina is a closed tube. The pessary can’t go anywhere else inside the body.

The vagnal pessary can fall out of the vagina if you strain or lift something. This usually means that your pessary is too small. Check with your doctor if your pessary keeps falling out. What else should I know? Many pessaries can be worn during intercourse–your doctor will tell you if you can’t. Be sure to tell your doctor promptly if you have any discomfort with the pessary or if you have trouble urinating or having a bowel movement.

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