2 LOCATIONS:   BETHESDA, MD. 4905 Del Ray Ave, Suite 508   |   MCLEAN, VA. 1305 Vincent Place

Introduction To Pessaries As A Treatment Option

Pessaries, what are they, and could they be the right treatment for you? If you’re dealing with a pelvic organ prolapse or with stress urinary incontinence, a pessary might be helpful for reducing your symptoms. In this post, we aim to provide you with a clearer understanding of pessaries as a treatment option.

What is a pessary?

When it comes to pelvic organ prolapse, one of the treatment options available is a pessary.

A pessary is an orthotic device that is fitted into the vagina with the intent of adding support and holding up pelvic organs that have dropped below their ideal anatomic position.  To help you get a better idea, a pessary is similar to a diaphragm but has a very different intent.

Unlike a diaphragm, a pessary is not designed for contraception. Instead, it serves as a supportive device for the pelvic organs, aiming to alleviate symptoms associated with pelvic organ prolapse.

A great thing about a pessary as a treatment option is that this solution is relatively non-invasive as the device is not a permanent fixture; it is removable. This allows for flexibility and ease of use tailored to individual needs and preferences.

Pessaries for Pelvic Organ Prolapse:

Pelvic organ prolapse is when one or more of the pelvic organs has fallen below its normal anatomic position. The pelvic organs include the bladder, the uterus, and the rectum, but this can happen with the small intestines as well.

When a pelvic organ prolapse happens, there is typically weakness in the pelvic floor muscles which are the muscles that should be supporting these organs. 

When the pelvic floor muscles are weak, working with a pelvic floor physical therapist on strengthening can be a helpful treatment. But another treatment option that may be helpful for certain individuals is a pessary.

A pessary for prolapse can provide support to the bladder, the uterus, and the rectum. While a pessary does not cure the prolapse, it does provide support  to these organs which can help to alleviate symptoms such as the sensation of bulging or pressure in the pelvic region.

Pessaries for Stress Urinary Incontinence:

Pessaries may also be beneficial in alleviating symptoms of stress urinary incontinence for certain individuals. Stress urinary incontinence is when you experience urine leaking during activities such as sneezing, laughing, coughing, or exercising.

When the bladder or urethra descends lower than their anatomically normal position, individuals may experience symptoms of stress urinary incontinence. A pessary may be helpful because it offers support to the urethra, the tube through which urine exits the bladder.

While strengthening the pelvic muscles with the guidance of a pelvic floor physical therapist is often recommended for many cases of stress urinary incontinence, a pessary presents as an additional option.

How do I know what type of pessary I need?

You need to be seen by a healthcare provider to be fitted for a pessary. This ensures that you will receive a device that is right for your specific issue as not all pelvic organ prolapses are the same!   

Pelvic organ prolapse can occur to the bladder, the uterus, or the rectum. There are also different stages of prolapse with stage 1 being the most mild and stage 4 being the most severe. When selecting a pessary, it’s crucial to consider these factors to align with your specific needs and the severity of your condition. This is why you need to be fitted for this device by a healthcare professional.

It’s also important to find the right fit for your specific anatomy. If a pessary is too small, it may fall out, and that won’t be effective at reducing symptoms! If a pessary is too large, then it may be uncomfortable to wear, and we don’t want that either!

During a pessary fitting, these factors, including the type of prolapse, its severity, and individual comfort, will be thoroughly addressed. This ensures the selection of the most effective and comfortable pessary tailored to your specific needs.

If you’re experiencing an issue with a pelvic organ prolapse or stress urinary incontinence, we’re here to help.

Thankfully, two of our pelvic physical therapy team members have undergone special training to help fit certain women with a pessary

Contact ITR Physical Therapy today at 301-770-7060 to schedule an appointment with our experienced Bethesda and McLean pelvic floor physical therapy team.