pelvic organ support devices (pessaries) for managine urinary incontinence

by Diane K. Newman, RNC, MSN, CRNP, FAAN

A pessary is a flexible device made of silicone that is used to reduce pelvic organ prolapse (dropping of pelvic organs like the bladder, uterus) in women. As women get older, their pelvic organs may drop down or sag. This is called prolapse (otherwise known as cystocele, rectocele, uterine prolapse). If this happens, women may find that they have to empty their bladders more often or have unwanted urine leakage. Women will report that they feel pressure in the area outside their vagina or a "bulging" sensation.

It has been found that by placing a pessary into the vagina, these symptoms can be relieved. A pessary is a device that looks like a diaphragm but the outside rim is hard. Like a diaphragm, it is put in the vagina to rest against the cervix to lift or support the pelvic organs. Pessaries come in many shapes, but are usually round. But they can be cube or "U" shaped. You should not be able to feel the pessary when it is placed inside you. Call your doctor or nurse if you have any vaginal discharge, itching, foul odor, or pain; cannot urinate, empty your bladder, or move your bowels; or if you have back pain.

The pessary can remain in place for several months and the woman can remove and clean it. Women who are pregnant, have an infection in their vaginas or who have had recent vaginal surgery should not use a pessary.

A specially designed "urinary incontinence" pessary can be effective in preventing a woman's urinary incontinence. Many available products are modified pessaries.

References

Newman, DK. Managing and Treating Urinary Incontinence. Health Professions Pr. 2002.

Posted: December 2003
Last updated: July 2009

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