Understanding Vaginal Pessaries for Pelvic Organ Prolapse: A Supportive Solution

Pelvic organ prolapse (POP) is a common condition affecting many women, particularly after childbirth or during and after menopause. It occurs when the pelvic organs (the bladder, uterus, or rectum) descend into or outside the vaginal canal due to weakened pelvic floor muscles, laxity in the vaginal canal or a reduction in ligamentous support.

The most common symptoms are:

• A visible bulge

• Heaviness or dragging

• A sensation of something (Iike a tampon) being stuck

• Pain

• Changes to bladder of bowel emptying

  
  

While POP can be distressing, it's important to know that effective, non-surgical treatments are available, and that you are not alone.

One such treatment is the use of vaginal pessaries. These devices can offer significant relief and are often recommended as a first-line, non-invasive option alongside Specialist Pelvic Health Physiotherapy.

What Is a Vaginal Pessary?

A vaginal pessary is a plastic or silicone device inserted into the vagina to support the pelvic organs, helping to alleviate symptoms of POP. The most commonly used type is the ring pessary, which is designed to hold the vaginal walls in place and reduce the bulging sensation. Pessaries are especially beneficial for women who wish to avoid surgery, are not candidates for surgical procedures, or prefer a reversible option. At Sussex Physiotherapy we fit medical grade silicone pessaries, which are safe, comfortable and supportive.

According to the National Institute for Health and Care Excellence (NICE), vaginal pessaries are recommended for women with symptomatic POP, either alone or alongside Specialist Pelvic Health Physiotherapy. They are considered a safe and effective alternative to surgery, particularly for women with moderate to severe prolapse, those who have not yet completed their family, or those who prefer a non-surgical approach.

The UK Clinical Guidelines for best practice in the use of vaginal pessaries, launched by the United Kingdom Continence Society in March 2021, provides comprehensive recommendations to ensure safe and effective use. This guideline emphasizes the importance of proper fitting, regular follow-up, and patient education to minimize risks and enhance outcomes .

Recent research, including the NIHR-funded TOPSY study, has shown that many women can safely manage their pessary use independently. Learning to insert, remove, and clean the pessary can offer greater control and flexibility, reducing the need for frequent clinic visits and promoting a sense of empowerment.

However, it is crucial to receive proper training from a healthcare professional initially and to have regular check-ups to monitor for any potential complications.

"Emily is a kind considerate expert. If you think there isn’t an answer to your prolapse then I can assure you there is. After 20 years of discomfort and pain... crossing your legs and not being able to run or walk properly... I am now a new woman. Emily explains why and what can be done and then she does it. My life is so much better - really better - going to play Padel next week which is all new to me. Life is great again - thank you Emily"

Vaginal pessaries offer a non-invasive, reversible, and effective option for managing pelvic organ prolapse. They can significantly improve quality of life, allowing women to engage in daily activities with greater confidence and comfort.

If you are experiencing symptoms of POP, consult your GP or book in for a consultation at Sussex Physiotherapy to see whether a pessary might be a suitable option for you.

Remember, seeking help is a positive step towards reclaiming your health and well-being. You're not alone, and support is available.

"Ive been to see Emily today, after having 2 years of prolapse misery, through lack of help and advise from both the NHS and the private sector. Within my first hour with her, i know that my journey going forward is going to be one that i can understand and deal with. Emily is so caring and clearly an expert in her field. (one that i didn't even know existed). Thank-you for bringing a hopeful spring back into my step..."