Vaginal pessaries are available in several different shapes and sizes. They are usually made of silicone, latex, or vinyl, and are fitted inside the vagina to support internal tissues displaced by pelvic organ prolapse.
Healthcare professionals should understand the pros and cons of each different type of vaginal pessary to help patients decide which type would best suit their needs.
When may a vaginal pessary be required?
Vaginal pessaries usually control the problems associated with prolapse of the vagina and/or the uterus. This option avoids surgery and is especially suitable for patients who wish to have more children. Patients may also choose to have a vaginal pessary inserted if they have medical conditions that make surgery unfeasible, or simply due to social circumstances.
Pelvic organ prolapse is very common, particularly in women who have previously given birth. Patents presenting with a prolapse may complain of discomfort, a ‘bulging’ feeling, incontinence issues and sexual difficulties.
What types of vaginal pessary are available?
Although there are several types of vaginal pessaries available, the commonly used ones are ring, shelf and Gellhorn pessaries.
Ring pessaries
Ring pessaries are soft and rounded. They will not prevent the patient from having sexual intercourse.
Shelf pessaries
These are like a saucer with a knob underneath. They are hard and will prevent the patient having sexual intercourse which is something that should be thoroughly discussed with them.
Gellhorn pessaries
These are similar to the shelf style but are soft. Again, they don’t allow for sexual intercourse.
Usually, ring pessaries are tried first simply because they’re the most practical. However, if the patient’s pelvic floor muscles are not strong enough to hold the ring in place, another style will need to be tried instead.
Vaginal pessaries are widely used across the UK with no problems. However, as with all medical treatments there’s always a risk of bleeding, dislodging or infection which should also be discussed in full with your patient before administering.
Are you a healthcare professional looking to understand more about common Gynae issues?
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