What is a pessary?
A pessary is a soft silicone vaginal prosthesis which is used to help support the vagina to manage prolapse or to reduce bladder leakage (stress urinary incontinence). A pessary is an alternative to surgery for women who are suffering from vaginal prolapse.
How do I know if I have a prolapse?
A Women’s Health Physiotherapist during an internal examination can assess if you have a prolapse and can discuss with you what management strategies are appropriate for your specific prolapse.
Sometimes women find out they have a prolapse when visiting a GP for a routine PAP smear. There are also signs women can look for to see if they have a prolapse – click here for signs of a prolapse.
How do I know if I need a pessary?
Deciding on if you need a pessary is an individual choice and one that the physiotherapist will discuss with you. Some of the reasons people decide to use a pessary to manage their prolapse are:
- Want more children
- Not a candidate for surgery
- Prefer conservative management
- Need some vaginal support during the first few postnatal years while returning to exercise
- Only have prolapse symptoms with certain activities and only want a pessary for that activity (for example with exercise)
- On a hospital waiting list for surgery but want relief now
What does a pessary look like?
There are many different types and shapes of pessaries, the type of pessary required depends on your individual prolapse. However, the two most common pessaries are the ring and cube shaped pessaries.
What should I expect when coming to Wisdom Physiotherapy for a pessary assessment?
You do not require a referral from your GP, however sometimes depending on your age (postmenopausal or early postnatal period) topical vaginal oestrogen maybe required before a pessary fitting can take place. You may have been referred by your GP or another physiotherapist, you will be booked in for an hour-long assessment.
The physiotherapist will discuss with you about your prolapse symptoms and this may include questions about your bladder, bowels, pain with sex, pelvic pain and any other medical conditions which maybe applicable.
An internal vaginal examination will be required to diagnose what type of prolapse you have and the severity (stage). The physiotherapist will then discuss with you what was found on internal examination and discuss all management strategies available including pessary fitting if it is essential to managing your condition.
If symptoms do not improve, we can liaise with a Urogynaecologist or Gynaecologist to look at the option of surgery.
How often do I need to come to see a physiotherapist if I have a pessary?
For a standard pessary fitting you will be required to have a review by the physiotherapist in 1-2 weeks after the initial assessment. Then a review with the physiotherapist in 4 months will be required and a yearly follow up with the physiotherapist.
The amount of physiotherapy treatments will depend on how well your pessary fits, how well your pelvic floor muscle contracts and relaxes, how many lifestyle factors need to be modified and how confident you are with pessary insertion and removal.
Are there any other checks I need to do for a pessary fitting?
A yearly speculum inspection with the GP or gynaecologist is required to check the internal vagina tissue health.
To discuss further or make an appointment for a Pessary Fitting by a Physio, please call (08) 6389 2947 or click here to book online. Our Pelvic Health Physio’s Amy Tinetti and Leah Kubale are both experienced in fitting pessaries.