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Pessary Management of Pelvic Organ Prolapse

Conservative non-surgical management of pelvic organ prolapse.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Pessary Management of Pelvic Organ Prolapse?

The pessary is a non-surgical treatment option for symptomatic pelvic organ prolapse, in which a silicone or rubber device of various shapes is placed in the vagina to support the prolapsed organs. It is a conservative approach used in patients who are not suitable for surgery, who prefer to defer surgery, or who have early prolapse.

Pessary types include the ring, gellhorn, donut, cube, and inflatable pessary; selection depends on the type and stage of prolapse, sexual activity status and patient ability for self-care. The ring pessary is most commonly preferred for stage 1-2 anterior compartment prolapse.

Approximately 60-80% of patients can tolerate the pessary in the long term. Regular follow-up is required (every 3-6 months); complications include vaginal discharge, ulceration, bleeding, infection and rarely vesicovaginal fistula. Concomitant low-dose vaginal oestrogen reduces complications in postmenopausal women.

Symptoms

Sense of pelvic pressure and heaviness
Vaginal bulge or protrusion
Voiding dysfunction (frequency, hesitancy)
Defecation dysfunction (constipation, incomplete evacuation)
Sexual dysfunction
Lower back pain
Recurrent urinary tract infection

Risk Factors

Postmenopausal status
Vaginal birth history (especially multiparity)
Advanced age
Obesity
Chronic constipation
Hysterectomy history
Connective tissue disorders
Smoking and chronic cough

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Symptomatic prolapse
  • Hesitancy regarding surgery
  • High surgical risk (comorbidities)
  • Postpartum prolapse
  • Incomplete urination
  • Recurrent infections
  • Pessary side effects (bleeding, discharge)

Treatment Methods

01
Detailed pelvic examination and POP-Q staging
02
Pessary type and size selection
03
Initial fitting and patient training
04
Vaginal oestrogen support (postmenopausal)
05
Self-care training (where possible)
06
3-6 monthly follow-up
07
Pelvic floor exercises (Kegel)
08
Surgical referral when necessary

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.