INSERTION AND CARE OF VAGINAL PESSARY. Barking, Havering and Redbridge University Hospitals NHS Trust

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1 INSERTION AND CARE OF VAGINAL PESSARY Barking, Havering and Redbridge University Hospitals NHS Trust

2 REASON FOR VAGINAL PESSARY Following your consultation with your doctor, it was decided that a vaginal pessary may be the best treatment for your vaginal wall or uterine womb prolapse. Insertion of a vaginal pessary is a good option for many women because it can provide relief from the symptoms of prolapse. Surgery is an alternative option, but is not guaranteed to be permanent and can have complications. TYPES OF PESSARIES RING PESSARY round in shape and comes in different sizes. The pessary can be white or pink in colour. Your doctor will assess you for the correct size. They are used for womb and other types of prolapse. SHELF PESSARY is a hard black plastic pessary. This pessary is used for women for whom the ring pessary does not stay in place.

3 GELHORN PESSARY this is similar in shape but is a pale pink colour. These pessaries are not suitable for women who are still sexually active due to the shape and the position of the pessary. Shelf and Gelhorn pessaries are much more difficult to insert and remove than the ring pessaries and are used in women for whom surgery is not an option either because they are unfit, or because they wish to avoid surgery. SIDE EFFECTS/RISKS Unfortunately pessaries are not suitable for everyone. The most common problem is that the pessary falls out (see below). For some women the pessary can be uncomfortable and occasionally it can make urinary incontinence worse. Most women with a pessary will have some vaginal discharge and this is normal. If you have an unpleasant discharge the pessary may not be suitable for you. However, any problems with a pessary are easily reversed on removing it. If you have a ring pessary and it is causing you discomfort or you feel your symptoms

4 are worse you can simply remove it yourself. You can do this safely by inserting a finger in the vagina and pulling on the ring. If you are very uncomfortable and not happy to do this, please contact your GP. If you have a Shelf or Gelhorn pessary and it is causing problems, you will need to attend the hospital. You will need to contact your consultant s secretary to have your appointment brought forward. IF THE PESSARY FALLS OUT Once the pessary has been inserted, your doctor will ask you to go for a walk around the department and to try and pass urine to ensure the pessary has been fitted securely. If the pessary falls out after you have gone home then, if you feel OK, you can wait until your next appointment to discuss further options with your consultant. However, if you are uncomfortable then you can contact your consultant s secretary to bring forward your next appointment. WILL THE PESSARY INTERFERE WITH GOING TO TOILET? No, it should not. CAN I EXERCISE WITH A PESSARY? A pessary should not affect your day to day life and you

5 should be able to do all normal activities with a pessary in place. WILL A PESSARY AFFECT MY PERIODS? A pessary will have no effect on your periods. should make you an appointment with a consultant obstetrician to discuss this further. It is not possible to have sex with a Gelhorn or Shelf pessary. HOW WILL A PESSARY AFFECT MY SEX LIFE? Many women with a Ring pessary are able to have sexual intercourse. For some women it is improved as they are no longer conscious of the appearance of the vagina. If you fall pregnant with a pessary in place it will not harm the pregnancy. As the pregnancy grows the prolapse is often lifted out of the pelvis and the pessary is no longer needed. Your midwife HOW OFTEN IS THE PESSARY CHANGED? There is no clear evidence for the optimum time for Ring changes. If a Ring is left in for more than a year it can become embedded and difficult to remove. If you have a Ring pessary and it is working well for you, it may be possible for the nurse or doctor at your GP surgery to change it for you. Other pessaries need to be changed in the hospital and we usually make an appointment for

6 this every six months. If your appointment is cancelled for any reason then you should make sure that you do not go for a whole year without having your pessary changed. IF I HAVE ANY CONCERNS ABOUT MY PESSARY WHAT SHOULD I DO? We hope this leaflet has answered any questions you may have about your pessary. If you are still unsure, you should contact your GP.

7 PATIENT NOTES Type of pessary inserted Ring pessary Shelf pessary Gelhorn Date pessary inserted.. Consultant... Consultant secretary name and contact number... Other notes

8 Created: November 2016 Review date: November 2018 PI number: 641