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Pessary Fitting

Pessary fittings are a service offered by our Women’s Health Physiotherapists at PEAK. Pessaries can be used to help treat symptoms related to Prolapse such as heaviness, bladder and bowel concerns, incontinence and lower back pain. Every body is different, therefore our Women’s Health Physiotherapists will complete a thorough assessment to ensure the right type and fit for you. Pessaries are usually used in conjunction with pelvic floor strengthening and advice and education to help with the management of your symptoms.

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What is a Pessary?

A pessary is a soft, flexible silicone device that is used to provide support to the pelvic organs like the bladder, uterus and bowel when there has been a loss of internal support to these organs. This is usually known as prolapse. A pessary is a non- surgical way to manage symptoms associated with prolapse and can allow daily activities or exercise to be performed with less symptoms. The device is usually inserted daily or can be used during specific tasks (exercising, heavy lifting). Pessaries come in different shapes or sizes depending on the person’s anatomy, type of prolapse and symptoms.

Pessaries have a low risk of complication if care instructions are followed. You will be required to have a follow up both with your Women’s Health Physiotherapist and also your GP at 3 months to check the health of the tissue. In certain circumstances you may be suggested to use a topical oestrogen to help with tissue health.

What is involved in a Pessary fitting at PEAK?

In your initial Women’s Health consult, whether you have been specifically referred for the service or have attended due to symptoms, the Physiotherapist will complete a thorough history and objective assessment. This will likely involve an internal exam. Depending on your symptoms, the exam and your own goals of treatment the Physiotherapist may suggest the use of a pessary for management of your symptoms. They will provide you with information on the device, use and risk factors and allow you time to decide whether you believe it is right for you. In your follow up session the coach will then spend time fitting the right device and size and teaching you how to insert, remove and care for the pessary.

You will be required to follow up 1 week later to check the fit and follow up with any concerns. You will also be asked to follow up at 3 months both with your GP for a Speculum exam and then with your Women’s Health Physiotherapist.

Pessaries need to be changed every 12 months and sometimes you may need to be refit for a pessary earlier if it is becoming difficult to insert/ remove or falling out.

What can Pessaries treat? Pessaries are used to treat symptoms related to Pelvic Organ Prolapse such as:

Pessaries can be useful in the management of prolapse even if you are waiting for surgery. Sometimes they can provide useful information as to how you will feel after the surgery and uncover underlying urinary incontinence which can change the type of surgery you may need.

Heaviness or pulling into the pelvis
Bulging
Difficulties with bowel motions
Lower back ache
Incontinence (not all) or urinary retention

Different types of Pessaries:

There are many different types of pessaries. They are all made out of silicone but differ in shape and size to provide support to different anatomy, prolapse types and symptoms.

FAQ's

What does a Pessary feel like?
A correctly fitted pessary should feel like it’s not there. If you have used tampons before, a pessary should fit like a tampon and feel comfortable. Sometimes, if you strain you may feel the pessary push down and become aware of it. In these situations, you can either push it back into place or remove and reinsert it again.
Do you wear a Pessary all the time?
Usually, you wear your pessary daily. You will insert the pessary in the morning and then remove it at night. In certain cases and types of pessaries you may wear it for longer. Similarly, you may also wear your pessary for certain activities rather than all the time. This will be discussed in your fitting session.
Can I claim my pessary with Private Health?
We are unable to make a claim with your Private health for the pessary on the day. Depending on the company and the level of cover you may be able to claim the pessary with your private health, the coach can write a letter confirming the use of the pessary is necessary for your treatment. You may want to contact your provider to check whether this is available to you.You can claim for the consultation on the day.