Historically, the use of pessaries to treat POP dates back to Hippocrates time. Throughout early medical history, pomegranates, honey, hot oil, wine, fumes, linen and cotton or wool soaked in many different potions were used as treatments. Succussion was a treatment which consisted of shaking a woman tied upside down to a ladder-like device to encourage the uterus to go back inside.
Pessaries are recommended as a first-line, relatively low-risk treatment option to treat a variety of symptoms related to pelvic organ prolapse. A pessary is a flexible, non-absorbent, non-surgical medical device often recommended to women to provide relief of pelvic organ prolapse symptoms. A pessary is a flexible device made from medical grade silicone (a few are made from acrylic, latex, or rubber). A pessary is inserted into the vagina to support sagging pelvic organs such as the uterus, bladder, or rectum, preventing them from pushing into the vagina or outside of the body. A pessary can also apply pressure against the urethra to prevent urinary leakage.
Health care providers fitting pessaries evaluate a woman’s individual needs, and assess vaginal space and shape, provide pessary education, and recommend follow-up instructions. Symptoms of pelvic organ prolapse that may benefit from pessary use are vaginal tissue bulge,urinary frequency, Urinary urgency, vaginal pressure, fecal urgency, fecal incontinence. Reasons to use a pessary are relief of symptoms, to avoid surgery, to clarify the benefit of surgical outcome, to prevent POP from getting worse. Reasons a woman may not be a suitable patient for pessary use include an active vaginal infection, a current vaginal erosion or ulcer, vaginal atrophy, or inability to see a clinician regularly for screening and follow-up.
In gratitude to Bioteque America, Inc, for sharing their Pessary Selection Chart and Pessary Type Images.