Vaginal Pessary: Causes, Symptoms, Treatment and Cost

A pessary is a device that is put into the vagina to support the pelvic organs. This type of pessary is known as a vaginal pessary. The prolapse of pelvic organs, urine incontinence, and other diseases that might cause discomfort in the lower abdomen are routinely treated using this method. Plastic, rubber, or silicone are the most common materials used in its construction, and it can come in a variety of forms and dimensions.

• Ring Pessary: This is the most common type of pessary, and consists of a ring-shaped device inserted into the vagina to provide support for the uterus or other pelvic organs.
• Gehrung Pessary: This type of pessary is used to treat uterine prolapse, and it is shaped like an upside down “U”. It provides support for the entire pelvic area, including the bladder and rectum.
• Gellhorn Pessary: This type of pessary is used to treat stress urinary incontinence, and it has a curved shape with a knob at the end that fits against the pubic bone. It supports the bladder neck to help reduce leakage during activities such as coughing or sneezing.
• Donut Pessary: The donut pessary is used to treat uterine prolapse and has a circular shape with a hole in the middle for urine flow through it. It provides support all along the circumference of your vagina and helps prevent further descent of your uterus or other organs in your pelvis due to gravity or physical activity.

• Non-surgical treatment option: A vaginal pessary is a non-surgical alternative to pelvic organ prolapse (POP) and urinary incontinence. It is easy to use and does not require any hospitalisation or surgical intervention, making it a convenient treatment option for many women.
• Cost effective: Pessaries are relatively affordable when compared to other treatments such as surgery, medications or physical therapy. Additionally, they may be covered by insurance plans in some cases.
• Quick recovery time: The recovery time for a vaginal pessary is usually between one and two weeks, with most women being able to resume normal activities within days of the procedure. Because of this, it is an excellent choice for women who do not have the financial means to pay for the downtime that is connected with surgery or other procedures.
• Minimally invasive: Since there is no cutting or stitching involved with the insertion of a pessary, there is minimal risk of infection or tissue damage associated with this treatment option.
• Reversible: Unlike surgery which may have permanent effects, the effects of using a pessary can be reversed if needed by simply removing the device from the vagina.

• A vaginal pessary is used to treat pelvic organ prolapse, a condition in which the pelvic organs, such as the bladder, uterus, and rectum, fall out of their normal position in the pelvis.
• Vaginal pessaries can also be used to help manage urinary incontinence.
• The purpose of a vaginal pessary is to reduce pressure on the pelvic floor muscles and ligaments so that they can regain their strength and support for the organs.

The risks associated with using a vaginal pessary vary depending on the type of pessary used. Generally, the most common risks include-

• Irritation and/or discomfort in the vagina and surrounding tissues.
• Vaginal discharge and/or odor.
• Increased risk of urinary tract infection due to increased moisture in the area.
• An increased risk of developing bacterial vaginosis if not removed regularly for cleaning.
• Potential damage to the cervix or uterus from an ill fitting pessary.
• Difficulty removing a pessary that has become stuck in the vagina.

• It is vital to have a conversation about the vaginal pessary insertion operation with your primary care physician and make sure that you understand the treatment's dangers and advantages before having the procedure done.
• You should also be sure to tell your doctor about any medications or supplements you are taking, as some of these could have an effect on the pessary’s effectiveness.
• To be ready for a vaginal pessary insertion, in addition to going over the process with your physician, there are a few other things you may do, including the following:
• Take a quick shower or bath before you go to the appointment so that you can appear nice and clean.
• Wear loose-fitting clothing to make it easier for your doctor to access the area where they will be inserting the pessary.
• Empty your bladder before going in for the appointment – this makes it easier for your doctor to insert the pessary properly and avoid discomfort during insertion.
• Bring a sanitary pad with you in case of any spotting after insertion – this is normal but should only last a few hours after insertion at most.
• Make sure that you have arranged transportation home after your appointment since you may feel tired or weak afterwards due to the effects of anesthesia (if used).

• Vaginal pessary can be inserted by a healthcare provider or self-inserted by the patient, depending on the type of pessary chosen.
• During insertion, lubrication should be applied to ensure more comfortable insertion and removal. Once in place, the pessary should be checked for proper positioning every few weeks to ensure that it remains comfortable and effective.
• In some cases, a healthcare provider may choose to fit a patient with an adjustable or removable pessary, which can be adjusted or removed as needed for greater comfort or convenience. Adjustable pessaries also allow for regular check-ups and adjustments as needed if symptoms persist or worsen over time.
• In some cases, surgery may be necessary if the patient experiences persistent pain or discomfort due to the presence of a pessary in their vagina. In general, however, vaginal pessaries are a safe and fairly non-invasive option for treating pelvic organ prolapse and urinary incontinence in women of any age.

Education regarding the procedure, including both its dangers and its potential advantages, ought to be provided to the patient.

The health care provider should discuss any possible complications that may occur, such as infection or displacement of the pessary.

• The procedure is usually done in a clinic or doctor's office and usually takes about 15 minutes.
• The patient is placed on her back and has stirrups placed under her feet.
• A local anaesthetic can be used to reduce discomfort during the procedure.
• The health care provider will then insert a speculum into the vagina to examine it and determine the size and shape of the pessary that best fits.
• The pessary is then lubricated and inserted into the vagina using a device called an inserter.
• The health care provider will adjust it so that it fits snugly against the walls of the vagina, but not too tightly so that it can be easily removed at home if necessary.

After a vaginal pessary is inserted, women should follow a few simple steps to ensure the best possible outcome. After the procedure, women should-

• Avoid strenuous activities such as lifting heavy objects or exercising for at least 24 hours.
• Take over-the-counter pain medication if needed.
• Wear loose-fitting clothing to reduce discomfort.
• Empty their bladder completely when they urinate.
• Monitor their symptoms closely and contact their doctor if there are any changes in their condition or if they experience any pain or bleeding from the insertion site.

The cost of a vaginal pessary insertion will vary depending on the type of pessary being inserted and the facility performing the procedure.

Generally, a basic pessary insertion can range from 500 Rs to 1000 Rs. More complex procedures may cost more.

• The best diet after a vaginal pessary is one that focuses on eating nutritious foods and drinks.
• This should consist of a substantial amount of fruits, vegetables, cereals with the bran intact, lean proteins, and healthy fats.
• In order to maintain proper hydration, it is essential to consume a lot of water.
• Avoiding processed and high-fat foods will help reduce the risk of any discomfort or side effects associated with the pessary.
• Additionally, it may be helpful to avoid spicy or acidic food as these can cause irritation in the vagina.

• Yes, vaginal pessaries are generally considered safe.
• However, like any medical device, it is important to follow the instructions for use provided by the manufacturer and consult with your healthcare provider if you have any questions or concerns.
• Additionally, there are certain conditions that can increase the risk of complications when using a vaginal pessary, such as an infection or pelvic inflammatory disease (PID).

Vaginal pessary typically does not cause pain. In fact, most women who use a vaginal pessary find it to be comfortable and barely even notice it.

However, some women may experience mild discomfort when first inserting the pessary due to the feeling of pressure or tightness.

Recovery from a vaginal pessary usually takes a few days. During this period, you may also have discomfort when peeing in addition to cramping and tightness in your lower abdominal region.

In order to allow the region to heal properly once the pessary has been removed, it is critical to get adequate rest and refrain from engaging in physically taxing activities for at least 24 hours. After the pessary has been removed, most women are able to resume their usual activities within a few days.

The most common side effects of vaginal pessaries are:

• Vaginal discharge
• Irritation and discomfort
• Urinary tract infection or irritation.
• Bleeding or spotting
• Pelvic pain or cramping.
• Intercourse difficulty or pain.
• Allergic reactions to the material of the pessary.

• Follow your doctor’s instructions regarding use of the pessary, such as when to wear it and how often to remove it for cleaning.
• Always wash your hands before handling the pessary, and always wash your hands after handling the pessary.
• Clean the pessary regularly with mild soap and water, rinse it, and air dry it completely before reinserting it in your vagina.
• If you experience any unusual symptoms such as pain or discharge, contact your doctor immediately for further instructions on how to proceed with care of your pessary device.
• Wear comfortable clothing that does not irritate the area around the vagina where the pessary is located (e.g., tight-fitting clothing).
• Avoid douching or using perfumed products near the vaginal area which may irritate or disrupt natural flora found in this region of the body.
• Avoid sexual activity during treatment with a vaginal pessary since this can increase risk of infection or cause discomfort while wearing a device.

The use of vaginal pessaries can provide relief from the symptoms of pelvic organ prolapse, urinary incontinence, and sexual dysfunction. Although not a permanent solution to these conditions, it can provide relief for some women who are unwilling or unable to undergo surgery.

The pessary should be chosen carefully and fitted correctly by an experienced clinician in order to ensure effective treatment and minimise the risk of complications. Overall, vaginal pessaries are a safe, effective option for some women with pelvic organ prolapse, urinary incontinence, and sexual dysfunction.