Pessary Fitting

A pessary is a soft, flexible device that is placed in the vagina to help support the bladder, vagina, uterus and/or rectum. Pessaries offer a non-surgical way to treat pelvic organ prolapse and sometimes incontinence.

Our pessary fitting process includes:

  1. a Pre-fitting assessment
  2. the Pessary fitting appointment
  3. the Pessary follow-up assessment
  4. ongoing medical follow-up appointments with my physician

Pre-fitting assessment

The pre-fitting assessment includes a thorough history-taking of current symptoms, 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-dependent positions and the effect on the prolapse
  • and rule out the presence of perineal scar tissue, pelvic floor muscle hypertonus and tissue sensitization

*Some women who have gone through menopause may benefit from using vaginal estrogen to prevent injury to the vaginal tissues. The estrogen cream can help to make the lining of the vagina thicker and healthier. There are also non-estrogen vaginal moisturizers which can be very beneficial to relieve symptoms of vaginal dryness and to improve the comfort of the pessary.

Your physiotherapist will be able to determine whether a  pessary fitting will be worth scheduling or whether it would be more beneficial to proceed first with a several sessions  of pelvic floor physiotherapy.

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

Pessary fitting appointment

The pessary fitting appointment includes:

  • a vaginal examination to note any baseline tenderness of the vaginal walls
  • a speculum exam
  • trial and error of a number of different pessaries until the best fit is found
  • practice inserting and removing pessaries
  • confirming complete bladder emptying
  • a review of pessary care and medical follow-up

Pessary follow-up assessment

The pessary follow-up assessment is a brief 15-min 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 with my physician after the pessary fitting are a critical part of the pessary fitting process to ensure that there are no complications to wearing the pessary. I understand that it is my responsibility to schedule follow-up appointments with my physician at 1, 3, 6 and 12 months following the pessary follow-up assessment, and annually from that point onwards.

Pessary benefits

The benefits of a pessary may include:

  1. Improved pelvic organ support
  2. Improved comfort and function and quality of life
  3. Improved bladder emptying
  4. Improved pelvic floor muscle strength
  5. Reduced urinary incontinence
  6. Preventing or avoiding surgery

Pessary fit

Your pessary is the right fit for you if:

  • it does not feel uncomfortable
  • you bear down and it does not fall out
  • you can empty your bladder fully
  • it is easy to remove every night and re-insert in the morning
  • it relieves your symptoms of prolapse and/or incontinence

Please email  Karine  or Heather  with any pessary questions.