How do you know if your Pessary fits correctly?
How to avoid problems with a poorly fitting pessary?
A well fitting pessary treatment for prolapse can help you exercise and stay active, ease prolapse symptoms, prevent worsening and avoid even avoid prolapse surgery.
This Pelvic Floor Physiotherapy information teaches you:
- The benefits of a well fitting support pessary
- 8 ways to know if your pessary fits you well
Benefits of a Well Fitting Pessary
Potential benefits for women with prolapse from a well fitting pessary device include:
- Decreased prolapse symptoms
- Prevent prolapse worsening
- More effective of pelvic floor exercises
- Avoid or delay prolapse surgery
- Manage pregnancy and prolapse after childbirth
- Manage repeat prolapse after prolapse surgery.
Speak with your gynaecologist or pelvic floor physiotherapist about your suitability for using a support pessary to manage your prolapse.
How to Know if Your Pessary Fits Well
Successful fitting usually means that the largest possible size device is fitted and sits comfortably within the vagina when you are standing upright.
Pessaries are available in a various sizes and styles to suit women’s individual differences and prolapse needs.
Prior to fitting your practitioner will assess your prolapse and measure the internal dimensions of your vagina to know the best size and style of device for your body.
A well fitting ring pessary is shown right.
8 Ways to Know if your Pessary Fits Well
1. Lying Down Flat Test
When lying flat your pessary may move down within your vagina when you cough, sneeze or hold your breath and strain however it shouldn’t move back when you relax.
If your device moves back when you relax you may need refitting with a larger size.
2. Standing Up Test
A well fitting pessary will not cause pelvic discomfort when standing up and walking.
When you cough, bend forwards, squat or hold your breath and strain the device should not move down out of your vagina. If the pessary moves to the entrance or out of your vagina you may require refitting with a larger size.
3. Bladder Emptying
The pessary should stay in place when you empty your bladder. It should not cause any change in bladder emptying such as difficulty initiating bladder emptying, slowing the flow of urine or feeling unable to completely empty the bladder.
Bladder emptying problems should be immediately reported to your treating practitioner. Learn the correct position and technique by viewing this bladder emptying video now.
4. Bladder Control
A well fitting pessary will not cause bladder control problems. Some pessaries are designed to manage both prolapse and stress urinary incontinence and may provide an alternative solution for some women seeking to manage both these problems if they coexist.
Bladder control training can assist with the management of ongoing bladder control problems.
5. Bowel Emptying
The pessary shouldn’t cause constipation or difficulty completely emptying your bowels. Bowel emptying problems should be reported to your practitioner.
Learn how to empty your bowels without straining by viewing this bowel emptying video now.
6. Physical Comfort
A well fitting pessary will not be felt within the vagina. When fitted, pessaries should not cause low abdominal or vaginal discomfort or pain in any upright or lying down position. Some women feel slight pelvic discomfort caused by the process of being fitted.
If you feel concerned about discomfort after fitting you should inform your practitioner who will assess you symptoms accordingly.
7. Fingertip Space
A well fitting pessary shouldn’t be too tight against the walls of your vagina. This can be checked by ensuring you can run a fingertip between the outer edge of the pessary and the vaginal walls.
8. Vaginal Bleeding
Vaginal bleeding when wearing a prolapse can be a sign of erosion of the vaginal walls and is this occurs, it does so after wearing the pessary for some time.
If you notice any unexplained vaginal bleeding contact your healthcare provider.
Pessary for prolapse management can make a great difference to the quality of a woman’s life and ability to stay active.
This list of the main indicators for successful fitting. If you are unsure about how well your pessary device is supporting your prolapse, speak with your health professional.
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out.
Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.