Pessary
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Introduction[edit | edit source]
A pessary is a conservative, minimally invasive device used to manage pelvic organ prolapse (POP) and stress urinary incontience.[1] The purpose of the pessary is to keep the POP from bulging beyond the opening of the vagina and help reduce symptoms associated with POP.
Pelvic organ prolapse is a condition where the pelvic organs descend below their anatomical position, causing alterations in the vaginal, genital canal, or rectal walls. [1]
Use of a pessary can provide immediate relief to symptoms associated with POP.
Indications for a Pessary[edit | edit source]
Symptoms of POP include:[1]
- A visible bulge
- Reports/feelings of pressure
- Voiding dysfunction
- Defecatory dysfunction
- Sexual dysfunction
Research has shown that pessaries are effective in eliminating symptoms of POP, improving QoL, improving patient's body image, and improving bowel symptoms. [2][3][4]
Pessaries can be used short-term or long-term.
Contraindications for a Pessary[edit | edit source]
- Short vaginal length
- Prior hysterectomy
- Prior POP surgery
Types of Pessaries[edit | edit source]
Pessaries are classified into Support, Space filling, and Incontinence groups.
Support Pessary[edit | edit source]
Support pessaries are used for all stages of POP.
Space filling Pessary[edit | edit source]
Space filling pessaries are typically used for more severe POP (stage s3 and 4).
Incontinence Pessary[edit | edit source]
Resources[edit | edit source]
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 https://aptapelvichealth.org/wp-content/uploads/2022/01/Position-Statement-Pessary-Fitting-and-Management-1.pdf
- ↑ Brazell HD, Patel M, O'Sullivan DM, Mellen C, LaSala CA. The impact of pessary use on bowel symptoms: one-year outcomes. Female Pelvic Med Reconstr Surg. 2014;20(2):95-98. doi:10.1097/SPV.0000000000000060
- ↑ Lamers BH, Broekman BM, Milani AL. Pessary treatment for pelvic organ prolapse and health-related quality of life: a review. Int Urogynecol J. 2011;22(6):637-644. doi:10.1007/s00192-011-1390-7
- ↑ Patel MS, Mellen C, O'Sullivan DM, Lasala CA. Pessary use and impact on quality of life and body image. Female Pelvic Med Reconstr Surg. 2011;17(6):298-301. doi:10.1097/SPV.0b013e31823a8186
