If your obstetrician or gynecologist determines that a pessary would be the right solution for you, there are bound to be some questions. That because most women don't hear of a pessary until they actually need one. There's a lot to learn about pessaries, including what they do and how to use them properly. When your medical professional decides this is the right option for you, ask any questions about pessaries that come to mind, including the following.
What is a Pessary and How Does It Work?
Pessaries are simple medical devices that are designed to help with a number of different pelvic issues. One of the most common applications has to do with continence problems. While your medical professional may employ other methods, the use of a pessary for incontinence can provide a great deal of relief.
Using pessaries requires insertion of the devices by means of the vagina. Once in position, the pessary offers support that is currently lacking and makes it easier to manage symptoms and avoid complications. Depending on the design of the pessary, it may also be a means of administering a steady flow of medication to help with the health issue.
Is There More Than One Type of Pessary?
There are several different types of pessaries available today. Each of the designs come in multiple sizes. Medical professionals determine which type and size is needed based on the condition or combination of conditions that the patient is facing.
There are pessaries that are elongated while other designs resemble a small doughnut. Some are in a “U" shape, while others are round and include carefully positioned perforations. Others have an open design and somewhat resemble a keyhole.
The various designs are typically categorized in one of three categories: therapeutic, pharmaceutical, and occlusive. Therapeutic pessaries provide support while pharmaceutical designs deliver medication in a manner that is easier absorbed through the vaginal walls. Occlusive pessaries are designed to function as a means of birth control.
Choosing the right type and size is not something that a medical professional does lightly. Since the goal is to provide a measure or relief to the patient either by supporting an internal organ or alleviating the distress associated with the health problem, it’s necessary to consider all factors that have led to the medical issue.
Keep in mind that while the first pessary used may turn out to be just right, it’s important to let your medical professional know if there’s any discomfort or any signs of infection after the device is inserted. It may be that a slightly different design will be better for your condition.
What Conditions are Treated Using Pessaries?
There are several conditions that can be treated using pessaries. In some cases, pessary rings or other designs may help when more than one condition is present.
Urinary incontinence is one example of a condition that pessaries can treat. With the proper design and placement, the device will help to prevent leakage that seems to happen without any warning. While it may not alleviate the need to use incontinence underwear, the pessary certainly provides the patient with an increased sense of control.
Prolapsed organs are another reason to be fitted with a pessary. In this scenario, the device will be shaped and sized so that it can provide support for the uterus, bladder, rectum, or vagina. Supporting the uterus is considered to be one of the more common reasons to receive a pessary.
Prevention of an unplanned pregnancy may call for using a pessary instead of an oral medication. The devices may also deliver some type of spermicide as part of the process. This solution is often used when the side effects triggered by using other means of birth control are severe.
What are Some Signs That a Pessary Might Be Needed?
In terms of dealing with a medical condition, pessaries may be the solution when the patient has a constant sense of heaviness or a dull ache in the vagina in general. When there is some difficulty controlling urine flow or if there is difficulty urinating at all, this type of device may be helpful. Pain in and around the general area of the anus may also be a sign that the device is needed.
Lower back pain that will not go away is another sign that medical attention is needed. In some cases, the origin of the pain will be associated with a partial prolapse of a pelvic organ. When that’s the case, a pessary is likely to be among the treatment options offered by the medical professional.
Bladder infections that seem to recur with regular frequency may indicate the need for a pessary. This is also true if issues with excessive amounts of vaginal discharge are frequent and don’t seem to respond to other modes of treatment.
Weakening of the ligaments supporting the uterus can also indicate the need for a pessary. This is a condition that is somewhat common for women who are going through menopause. The result is that the uterus does not feel quite as secure and seems to feel out of position. While laying in a prone position helps, the sensation that something is out of place returns while standing upright, walking, or attempting to exercise.
While some may associate the use of a pessary with life after undergoing menopause, women of all ages can experience one or more of these signs. That means it’s also possible for a woman in the prime of her child-bearing years to develop a condition that can be treated using the device.
How Do You Insert a Pessary?
Depending on the design, it may be necessary for a medical professional to insert the pessary. Your medical professional will advise you if there is the need to come in to check, change, and insert a fresh device.
In other cases, the patient is able to manage the care and use of the pessary without a medical professional being present. When that’s the case, the professional will typically teach the patient how to manage the insertion, what signs make it clear the device is in the proper position, and how to remove it for cleaning.
It’s a good idea to keep several pessaries on hand. The goal is to ensure there is always a sterile one ready for use when the previous one is removed. The patient may also want to consider the use of disposable pessaries, since they are sealed and can be inserted using applicators that are much like those used to insert tampons.
How Long Can You Leave a Pessary In?
One of the things you should learn about pessary insertion is how long the device can remain in position. A lot depends on the nature of the health issue you are treating. In some cases, it may be necessary to remove and clean the pessary daily or at least every other day. There are situations in which pessaries may be left in place for as long as three months.
Remember that if you are removing the pessary in order to clean it, make sure the activity does not cause irritation to the vaginal walls or opening. Cleanings that are too frequent can cause irritation and may exacerbate the underlying health issue.
The best way to know how long the pessary can remain in is to work out a schedule with your physician. The frequency of the change will depend on the nature and severity of the issue you are living with. That schedule may change over time, especially if you are receiving other treatments for that condition. Assuming that your body responds to those other modes of treatment, it may be possible to remove and clean the pessary less often. You may even be able to eventually discontinue use of the device altogether.
How Do You Clean a Pessary?
If you want to clean your pessaries properly, start by finding out what material is used to manufacture the devices. You’ll find that many of them are made using silicone. That’s actually a good thing, since bacteria is less likely to grown on medical grade silicone. That makes the task of cleaning the devices a lot simpler.
The manufacturer will recommend the type of cleaning products to use. Remember that you want your hands to be clean before you do apply any type of cleaning agent to the pessary. Prepare by washing your hands using an anti-bacterial soap and drying them on a clean towel.
In many cases, the same type of soap you use to wash your hands will also do fine for washing the pessary. The soap should be unscented and have anti-bacterial properties. You will want to dry the pessary using a sterile cloth. If you have already inserted a clean pessary, take the one you just cleaned and wrap it in sterile material and place it in an airtight container. That will ensure it’s ready for use when necessary.
Are There Possible Side Effects?
There are a few possible pessary side effects that you should recognize. A medical professional will go over known side effects with you before the first insertion. You can also learn more about known side effects by reading the materials that come with the device.
You may experience some amount of vaginal irritation that was not present before. If so, that could mean the position or the shape of the pessary is not right for you. Changing to a different design or size could alleviate the discomfort.
If you did not have excessive discharge before and now the volume has increased and the scent is more pungent, that could mean a complication is present. In this scenario, you would want to schedule an appointment with your gynecologist and determine what’s happening. A change in the type and size of pessary may alleviate the odor and the additional discharge.
The development of a urinary tract infection is also possible. You will notice the increase in pain and difficulty urinating. Opting for a different type and size of pessary coupled with treating the infection will often prevent the issue from recurring.
Since pessaries are removable, the process of dealing with the side effects is usually simple and fast. Report anything unusual to your medical practitioner and it won’t take long to resolve the issue and find the right kind of pessary to help with your other health issues.
How Much Do Pessaries Cost?
The cost of purchasing pessaries varies based on the design and size. As of 2018, reusable pessaries generally run over $100 CAD for each unit. Disposable pessaries are generally lower but may or may not last that long. Even so, the disposable variety may be fine for the condition you are treating. Your gynecologist can provide suggestions on which type of pessaries would work best in your case.
Remember that health insurance often covers all or part of the cost. If your policy does not, there are discount health plans that will help manage the expense. You will find that some health savings plans also allow clients to use the funds in their accounts to pay for medical supplies like pessaries.
Can You Buy a Pessary Over the Counter?
In some nations, pessaries of any type can only be purchased with a prescription. Other countries allow all sorts of pessaries to be purchased over the counter. That includes ordering the devices from an online supplier.
When your gynecologist recommends a certain type of pessary, ask if it can be purchased without a prescription. The medical professional will know what laws and regulations apply in your area and will ensure you have a prescription if it’s necessary.
There’s no need to suffer pain while your doctor determines if some type of surgery is needed to correct a pelvic issue. When a pessary will provide support, help with incontinence, or provide some other type of relief, go ahead and try one. Doing so will make it much easier to manage the condition while you and your medical practitioner decide what will happen next.