A pessary can avoid the need for surgery.

Prolapses of the womb, bladder and rectum are common. Surgery can often fix these, or your doctor may recommend the use of a pessary, a non-surgical supportive device.

The word pessary comes from the Ancient Greek pessarion, referring to a piece of medication-soaked wool or lint which was inserted into the vagina. The Greeks also used pessaries to prevent pregnancy, and as a kind of early tampon.

Pessary options

A pessary is used to treat prolapses that occur after surgery or childbirth, when the uterus slides into the vaginal canal due to weakness of the pelvic muscles and ligaments that should support it.

Prolapses can cause pain and discomfort, on top of other health problems; use of a pessary can greatly reduce symptoms and improve quality of life for women of all ages.

Pessaries can be also used for women who have serious chronic health problems such as heart or lung disease that make a surgical procedure more dangerous, and are an effective treatment for stress urinary incontinence (the leaking of urine when you cough, strain or exercise).

Woman with doctor 

Prolapse?

Mild prolapses may not give symptoms. More severe ones can cause feelings of fullness, a bulge in the vagina, difficulty passing urine, urinary frequency, pelvic or rectal pressure, constipation, or leakage.

There may be a feeling of not fully emptying the bowel or bladder.

Any prolapse can also affect sexual comfort, interfering with penetration and causing pain.

Self management

Typically made of silicone, pessaries are available in various styles and sizes. A doctor may try several types to find one that works best.

They can be worn for days to weeks at a time before they have to be removed and cleaned with simple soap and water.

You may be able to do this yourself at home. Or, your doctor may suggest regular appointments to check the device.

Vaginal pessaries can usually be worn during sex (ask your doctor). Tell your doctor promptly if you have any discomfort with the pessary, or trouble urinating or moving your bowels.

In post-menopausal women, oestrogen (cream, ring, or tablets) is sometimes used to help with irritation caused by the pessary.

Free advice!

If you have questions about uterine, bladder, or rectal prolapse, you can receive confidential advice from your doctor or the NZ Continence Association.

Phone the National Continence Helpline on (0800) 650 659.

A pharmaceutical pessary

This is made by blending drugs with a substance which dissolves in the warmth of the body. Drugs slowly leach through the porous membrane of the vagina. A pessary used in the rectum is better known as a suppository, which can be used as an alternative to pills and injections. Some medications must be specifically delivered vaginally or anally to be most effective.