Do you sometimes feel like something is coming down from your vagina, like it's heavy or full? Or do you accidentally leak a few drops of urine when you laugh out loud, cough, sneeze, or exercise? This is actually a common problem among many women, but they are a little reluctant to talk about it. But there are effective solutions that can be done without surgery. That's what we're talking about today.
Simply put, what is a pessary?
Very simple. A pessary is a small device made of soft silicone that your doctor can insert into your vagina and remove if necessary. It can be shaped like a ring or other shape.
Now look, the important organs in our pelvic cavity, such as the uterus, bladder, and rectum, are held in place by the pelvic floor muscles, like a net or a cradle. These muscles are what keep these organs in their proper places.
However, after childbirth, as you get older, or because of frequent lifting, these muscles can become weak. Then, the organs lose their support and gradually descend. We call this Pelvic Organ Prolapse (POP) . Many people know this as "uterine prolapse." Also, when these muscles become weak, the condition that occurs when you cough or laugh, which is called stress incontinence, occurs.
So what a pessary does is provide support to these lowered organs, put them back in their original position, and eliminate the discomfort you're feeling.
What are the main types of pessaries?
Pessaries come in a variety of shapes and sizes. Your doctor will choose the one that best suits your condition and body type. Let's take a look at the most commonly used types.
| Pessary Type | Description and use |
|---|---|
| Ring Pessary | This is the most commonly used type. It looks like an O-shaped ring. It is used for mild prolapse and urinary incontinence. It is easy enough to remove, clean, and put back on yourself. |
| Gellhorn Pessary | This is a disc-shaped device with a small button in the middle. It is used for cases of severe prolapse. It not only provides support, but also fills the upper part of the vagina and prevents the penis from coming down. |
| Donut Pessary and Cube Pessary | These are also other types used for severe prolapse. They come in a round shape like a donut, a fat one, and a square cube shape. These also help to keep the vagina full. |
Your doctor will decide which of these types is right for you.
How does the doctor insert a pessary?
Although this is something that many people are afraid of, it is actually not painful. This is how a pessary is inserted when you go to see the doctor.
- First, a pelvic exam is performed: The doctor will examine your vagina and surrounding organs. The right pessary for you will be selected based on factors such as the severity of your prolapse, the length, and size of your vagina.
- Choosing the right type and size: This is very important. If the pessary is too small, you may not notice it, especially when you go to the toilet. If it is too large, you may feel discomfort and pain. Therefore, it is essential to find the right size.
- Inserting the pessary: The doctor will insert the pessary very gently, using a lubricant. If you feel uncomfortable, a numbing medicine may be applied to the vaginal opening. So don't be afraid, talk to your doctor about how you feel.
- Checking if it's working properly: After the pessary is inserted, you will be asked to stand up, sit down, bend over a little, and cough. This is to make sure it's in place without coming out. They will also check if you can urinate easily.
Remember, don't worry if you don't get the right fit the first time. It may take a few tries to find the right fit for you. Your doctor will help you.
What are the things to pay attention to when using a pessary?
A pessary is a largely safe treatment. However, you should be aware of any changes in your body. If anything happens, you should tell your doctor immediately.
| Feature to pay attention to | What does it say and what should be done? |
|---|---|
| Pain or discomfort | This often means that the pessary does not fit properly. You may need a different size. Tell your doctor immediately. |
| A pink or bloody discharge | This means that the pessary is rubbing against the vaginal wall. You may need to use a different size pessary or leave the pessary out for a while until the skin heals. Tell your doctor about this. |
| An unusual, foul-smelling discharge | It's normal to have a white discharge when you have a pessary in place. But if it smells bad, it's a sign of an infection. You may need to take antibiotics for this. See your doctor immediately. |
How do you keep a pessary clean?
If you have been given a ring pessary that you can remove yourself, it is very easy to keep clean. Your doctor will show you how to do this. Usually, you can remove it once a week or every night and clean it.
- First, wash your hands thoroughly with soap.
- Then slowly remove the pessary.
- Wash it thoroughly using a mild soap and water.
- Let it dry thoroughly before putting it back on.
If you have a type like Gellhorn that you can't remove yourself, you'll need to go to the doctor every 3 to 6 months to have it cleaned and the condition of the vagina checked. These follow-up visits are a must.
Is a pessary better? Or is it surgery?
This is a question that many people have. The answer is really, "It varies from person to person."
In many cases, using a pessary can help control symptoms without resorting to major surgery. That's the main advantage . Also, pessaries are inexpensive and safe to use.
But this doesn't work for everyone.
- Time to find the right fit: It can be a bit tiring to have to try several times to find the right pessary for you.
- Maintenance: Having to visit the doctor frequently can be a hassle for some people.
- Sexual intercourse: While it is possible to have sex while wearing a ring pessary, types like the Gellhorn should be removed beforehand. This requires the help of a doctor, and can be disruptive to some people's lifestyle.
- Not a long-term solution for everyone: For some, a pessary is a good long-term solution, but for others, surgery may eventually be necessary.
Ultimately, you should decide whether a pessary or surgery is best for you by talking to your doctor, considering your health condition, lifestyle, and the nature of the problem.
Take-Home Message
- A pessary is a successful, non-surgical solution to conditions such as uterine prolapse and urinary incontinence.
- It is very important to choose the right pessary for you and have it inserted by a doctor.
- If it is a type that you can remove and clean yourself, clean it regularly according to your doctor's instructions. Otherwise, see your doctor at the scheduled time to have it cleaned.
- If you experience pain, unusual bleeding, or foul-smelling discharge after inserting the pessary, notify your doctor immediately.
- Discuss with your doctor whether this is the right treatment for you. Don't be afraid or embarrassed to talk about your problem.
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