ÃÛÌÒAPP
As a nurse-led vaginal pessary service, we aim to provide safe, supportive and personalised care to help improve your comfort, confidence and quality of life.
What is a vaginal pessary?
A vaginal pessary is a non-surgical option for short or long-term use (depending on individual needs).
It is a removable device placed inside the vagina to help support pelvic organs that have prolapsed (dropped down). It can relieve symptoms such as the feeling of heaviness, dragging, bulging or discomfort, and may also aid improving urinary issues.
Who will provide my care?
Your care will be provided by a specialist nurse who is trained in pessary assessment, fitting and ongoing management. They will work closely with consultants, physiotherapists and your GP to ensure safe and effective care.
What happens at my appointment?
The urogynaecology nurses will discuss your lifestyle, symptoms, expectations and options in relation to vaginal pessaries to manage your prolapse.
With your consent, we will perform a vaginal examination to assess whether a pessary is appropriate and identify size/type personalised to you. You can trial a pessary during your first appointment if you wish to proceed.
We can also teach you how to insert and remove certain pessaries, so that you can self-manage your prolapse to suit your daily living/activities.
You will have the opportunity throughout the appointment to ask questions and will be involved in decisions about your care.
Will fitting the pessary be painful?
Most women find pessary fitting uncomfortable rather than painful. The nurse will explain each step, use lubrication, and proceed at a pace that feels right for you.
You can ask the nurse to stop at any time. If appropriate, some clinical areas have access to Entonox (gas and air) for comfort. Please discuss this with the nurse at your appointment.
Will I feel the pessary once it’s in place?
Pessaries, when fitted correctly, should not be felt during daily activities. You may have some awareness initially, but this should settle.
If you experience pain, bleeding, or difficulty emptying your bladder or bowels, we recommend that you contact the service for advice.
How long can the pessary stay in?
You will be scheduled follow-ups if you have a pessary inserted. This will depend on the type of pessary you have and your individual circumstances.
We generally review pessaries at either 6 or 12 months. However, it is not unusual for your nurse to request a follow-up earlier or later than this, based on their clinical judgement. If you have any questions, please contact the service for advice.
Some women prefer to self-manage their pessary (remove, clean and re-insert themselves), this will be discussed as part of your initial appointment, as this is not always suitable or appropriate.
Why do I need a follow-up?
Follow-up appointments are essential to make sure the pessary remains safe and effective. With your consent, during your follow-up we will remove and check the pessary, assess vaginal health and refit or change the pessary if needed.
Are there any risks or side effects?
With appropriate management, pessaries are generally very safe.
Possible risks include
- Vaginal discharge, bleeding, irritation, soreness or ulceration.
- Urinary symptoms – some women experience reduced ability to pass urine or instead pass urine more frequently or feel unable to control their bladder (urinary incontinence).
If you experience any of the issues described above, please contact the service for advice.
We may identify some of these issues during your follow-up appointment, and we can provide you with advice and guidance.
Using vaginal oestrogen, if appropriate, can help reduce risks or side effects.
Can I be sexually active with a pessary?
This depends on the type of pessary used. Your nurse will discuss this with you as part of your initial appointment and subsequent appointments. If you would like to remain sexually active, we will try to provide the right pessary for you.
What if the pessary doesn’t work for me?
Pessaries do not always suit everyone. Sometimes it takes a few attempts to find the right size and type for you. If pessary management is not successful or comfortable, alternative options can be discussed.
Who do I contact if I have queries or issues with the pessary?
You will be given contact details for the urogynaecology nursing service and their secretarial support.
Due to clinical commitments the nurses are not always available to respond to calls. The secretarial are appropriately trained to ask specific questions, which will allow them to triage your call.
The secretarial team are not clinically trained and therefore may not be able to provide advice. They will escalate your query/concern accordingly.
The nursing team will assess you on an individual basis. Based on your circumstances, we will arrange for the next available telephone or face-to-face appointment. We are unable to provide a specific timeframe for this.
If you have a ring pessary in place, please contact your GP in the first instance. If you have been taught to remove the pessary, try to remove it before contacting the nursing team.
We are not an emergency service. If you feel that you need to be seen urgently, please speak with your GP or attend your nearest emergency department.
Please do not attend the women’s health unit without an appointment. We can also not guarantee we will be able to call you back.
