Pessaries: What They Are and How They Help With Pelvic Prolapse

As women’s health issues go, pelvic organ prolapse (POP) ranks among the most common. By the numbers, pelvic organ prolapse affects about 40% of women around the world. Closer to home, the statistics border on alarming — by 2050, one scientific paper predicts that the number of women with POP will increase by 50%.

Given the prevalence of pelvic organ prolapse, the team of gynecology specialists here at Women’s Clinic of the Rio Grande Valley, which is led by Dr. Fernando Otero, is going to focus on one of the frontline treatments for this issue — a pessary.

Here’s a look at this incredibly simple solution to a growing problem.

Pelvic organ prolapse basics

To have a better grasp on how pessaries work, it’s useful to fully understand what we’re up against with pelvic organ prolapse.

Your pelvis and lower abdomen form a cavity that houses a number of organs and systems. For starters, your reproductive organs are found in your pelvis. As well, your lower urinary tract and lower digestive tract are also located inside your pelvis.

To help keep these numerous organs in position, you have a band of tissue beneath them that forms a hammock — your pelvic floor. If this floor weakens, your pelvic organs can shift out of place and descend. Organs that may be affected include your:

• Uterus
• Bladder
• Urethra
• Small intestine
• Rectum
• Top part of your vagina (it collapses into itself)

Depending on which organs are shifting out of place, you can experience functional symptoms like incontinence, as well as discomfort. In extreme cases, the prolapsing organ can protrude out of your vagina. 

There are many reasons why a pelvic floor can weaken, including:

• Pregnancy
• Childbirth
• Obesity
• Aging

The last two on this list, aging and obesity, are behind the projected increase in POP in the US as our population ages and gains weight.

Restoring support with a pessary

The two frontline treatments for POP are pelvic floor exercises called Kegels to strengthen the support muscles and pessaries.

The pessary is an amazingly simple device — it’s a small object that you place inside your vagina to keep organs from shifting down and out. We may also recommend a pessary to help with stress incontinence if your bladder or urethra is prolapsing.

There are several types of pessaries, including:

• O-shaped ring pessary
• Gelhorn pessary, which is a disc with a knob in the center
• Donut pessary, which is thicker than the ring pessary
• Shaatz pessary, which is a simple disc
• A cube pessary with concave sides that suction to the walls of your vagina

Based on your degree of POP and which organs are affected, we choose a pessary that gives you the best results.

Rest assured, we show you how to use the pessary during an in-office visit, which allows you to insert and remove it when needed. We promise that it’s easy once you know how.

That said, some pessaries are designed to stay inside until your next visit, while others can be removed every night for cleaning or for intercourse.

If you want to explore whether a pessary can help with your POP symptoms, we’re here to help. To get started, we invite you to contact one of our offices in McAllen or Edinburg, Texas., to schedule a consultation.