Pessaries are used to support your pelvic organs (bladder, urethra (tube you pee through) uterus, rectum, and small intestine) when you are experiencing stress incontinence and/or prolapse. They are small silicone devices that you cannot feel (when fit correctly) that can quickly and effectively resolve the bothersome symptoms some people experience. Let’s talk about when someone would benefit from a pessary.

Prolapse is when an organ is moving or falling down lower than it should within the pelvis. Sometimes prolapse is called a cystocele, rectocele, uterine prolapse, or anterior or posterior vaginal wall prolapse. People with prolapse usually feel a bulge at their vagina or describe a dragging, heaviness, or falling out sensation. We treat prolapse a lot with physical therapy, but sometimes a pessary can make our treatments more effective or help our clients see results sooner.

Stress incontinence (leaking with coughing, sneezing, lifting, jumping, standing up from a chair, running, walking) is multifactorial and at our office we are able to stop people from leaking all the time. Most of our clients are fully dry pretty quickly, but sometimes the reason someone has leakage means it takes longer for them to recover or they do not get totally dry with exercises. In some situations, pessaries can be used to help you get totally dry faster.

Sometimes people will need to wear a pessary long-term, some people only need a pessary for a short time, and some people use a pessary occasionally or even only when doing a specific activity. Our job is to help you figure that out, and set you up for success.

You might want to consider a pessary if:

1. You feel a bulge or sensation of something falling out vaginally

2. You have tried physical therapy for your stress incontinence and were not able to stop all the leaks

3. You want to avoid surgery for prolapse or stress incontinence

4. You have prolapse, and want to have more children

5. You had a difficult delivery including significant tearing or forceps delivery

Ask your physical therapist if a pessary is right for you.