Pessary Fitting

Referrals

If you are a health professional and would like to refer a client for a pessary fitting, please complete this form (PDF, DOC) and return it to us by fax at 613-907-1352.

If you are a new client who has been referred for a pessary fitting by your pelvic health physiotherapist, please have your physiotherapist complete the pdf form above and return it to us by fax.

A pessary is a soft, flexible device that is placed in the vagina to help support the bladder, vagina, uterus and/or rectum in the case of pelvic organ prolapse. Pessaries offer a non-surgical way to reduce pelvic organ prolapse symptoms, to improve bowel and bladder emptying, to prevent a prolapse from getting worse, to delay or prevent surgery, to reduce incontinence, and to facilitate improved activity tolerance.  

The pessary fitting process includes:

  1. a pre-fitting assessment
  2. a pessary fitting appointment
  3. a pessary follow-up assessment
  4. ongoing medical follow-up appointments with a physician

Pre-fitting assessment

The pre-fitting assessment includes a thorough history-taking of current symptoms, and medical and pelvic health history.

A vaginal exam is required to assess:

  • the quality of the skin and vaginal tissues*
  • the type and degree of prolapse
  • functional movements which provoke symptoms
  • pelvic floor muscle strength in gravity positions
  • whether there are any factors that might delay the pessary fitting such perineal scar tissue, pelvic floor muscle hypertonus and tissue sensitization

*Some women may benefit from a 1–3 month course of local vaginal estrogen to help make the lining of the vagina thicker and healthier. Non-estrogen vaginal moisturizers can also be very beneficial to relieve symptoms of vaginal dryness and to improve the comfort of the pessary.

The key findings of the assessment are summarized in a pessary authorization form and faxed to the physician or specialist. The pessary fitting consent and pessary care forms are reviewed. Once the pessary authorization form is signed and returned to us by fax we can proceed with booking the pessary fitting appointment.

Pessary fitting appointment

The pessary fitting appointment includes:

  • a vaginal assessment to note any baseline tenderness of the vaginal walls and a speculum exam
  • trial and error of a number of different pessaries until the best fit is found
  • instruction in inserting and removing the pessary
  • a review of pessary care and medical follow-up

Pessary follow-up assessment

The pessary follow-up assessment is a brief 15-minute appointment carried out 1-2 weeks after wearing the pessary daily. The vaginal walls are palpated for any signs of tenderness and a repeat speculum exam is done. Pessary care is reviewed and any questions or concerns are discussed.

Ongoing medical follow-up appointments

Ongoing medical follow-up appointments are necessary to ensure that there are no complications to wearing the pessary. Follow-up appointments with a physician, your fitting physiotherapist or another designated health care professional, such as a nurse care practitioner, are recommended at 1, 3, 6 and 12 months following the pessary follow-up assessment. From that point onwards, it is recommended that the client have a medical assessment once per year to have the tissues assessed. 

Pessary benefits

The benefits of a pessary may include:

  • Improved pelvic organ support
  • Improved comfort and function and quality of life
  • Improved bladder and/or bowel emptying
  • Improved pelvic floor muscle function
  • Reduced urinary incontinence
  • Preventing or avoiding surgery

Pessary fit

Your pessary is a good fit for you if:

  • you are not aware of it when wearing it
  • it feels supportive
  • you can empty your bladder and bowels fully
  • it is easy to remove every night and re-insert in the morning
  • it reduces or clears your symptoms of prolapse and/or incontinence
  • it enables you to be more active and feel more comfortable
  • it helps to prevent or avoid surgery

Please email our receptionist with any pessary questions!

Any of of our pelvic health physiotherapists would be happy to discuss your questions with a complimentary phone consultation.