You might not have heard of pessaries before, but they’ve been around in one form or another for centuries. These small, removable devices are inserted into the vagina to provide non-surgical relief for pelvic organ prolapse (POP). They are also far more common (and simple to use) than you may expect.
Pessaries and Pelvic Organ Prolapse (POP)
The muscles and tissues that support the pelvic organs (including the bladder, uterus, cervix, vagina, and rectum) hang together much like a hammock. “A prolapse happens,” the Office on Women’s Health explains, “when the pelvis muscles and tissues can no longer support these organs because [they] are weak or damaged.” As a result, one or more of these pelvic organs may drop from its standard position, or even press into or out of the vagina.
This type of pelvic floor disorder can involve:
- Urinary incontinence (leaking of urine)
- Fecal incontinence (leaking of stool)
- Weakening of the muscles and tissues supporting the organs in the pelvis
- Pain during intercourse
- A feeling of heaviness or pressure in the vagina
According to the National Association for Continence, “In addition to childbirth, risk factors for the development of POP include a family history of POP, obesity, advancing age, prior hysterectomy, and conditions that chronically increase intra-abdominal pressure, such as asthma or constipation.”
Though some women opt for surgical solutions to POP, pessaries are less invasive—providing support for the prolapse, or filling gaps caused by it.
Besides providing symptom relief and improved quality of life, pessaries are also fairly easy to maintain. A study reported in the Journal of Obstetrics and Gynecology Canada concludes that any major complications were the result of cleaning and maintenance neglect, and any “Minor complications such as vaginal discharge, odor, and erosions can usually be successfully treated.”
Pessary History and Composition
POP is described in the Egyptian Kahun Gynaecological Papyrus — the oldest documented medical literature we know of. But it wasn’t until the end of the sixteenth century that pessaries became more widely and safely used. Early versions were composed of wax, wood, glass, metal, leather and even Bakelite.
The main difficulty surrounding the first pessaries was that they were made from materials that could decompose within the body. The first “incorruptible” pessary was developed in 1844, “when Charles Goodyear was granted U.S. patent no. 3,633 for the invention of vulcanized rubber,” as described in a 2012 article published by Hindawi.
Currently, there are three types of pessaries: the doughnut pessary, ring pessary with support, and Gelhorn pessary. Generally, these are made of silicone, and are easy to remove and replace for cleaning.
Which one is best for your body? The Global Library of Women’s Medicines advises that “The choice of pessary depends on a variety of factors including type and degree of prolapse . . . the type of pessary the clinician has available . . . and whether the patient desires to manage her pessary at home, as some pessaries cannot be self-removed.” But consultation with your gynecologist can help determine the best solution.
If you’re concerned about POP symptoms, curious about a pessary fitting, or would like to discuss other options for POP relief including a routine for pelvic floor exercises, contact our team at (404) 352-2850 or schedule an appointment online for a consultation.