Pessary for Prolapse
Your guide to pelvic health pessary care
What is a prolapse?
A prolapse is a dragging, bulging or heaviness sensation around the vagina cause by the bladder, bowels or the uterus pushing the vaginal walls towards the entrance of the vagina. This can come and go and often feels worse the end of the day or if you need a bowel movement.
What is a pessary?
A pessary is a gentle, non-surgical device designed to give your pelvic organs the extra support they need. Made from soft, medical-grade silicone, these devices come in a wide variety of shapes and sizes to match your unique anatomy. When a pessary fits your body perfectly, it should be completely comfortable and you should not feel it, or your prolapse, at all.
Depending on your personal needs and the type of device chosen, some pessaries are designed to be removed daily, while others can be left safely in place for three to six months. If it feels right for you, our specialist pelvic health physiotherapist can teach you how to confidently manage your pessary yourself at home—including how to gently take it out and put it back in.
Why consider having a pessary?
Living with the heavy, uncomfortable symptoms of a prolapse can feel deeply frustrating however we are here to support you. Alongside tailored pelvic floor exercises, weight management, and simple lifestyle adjustments, a pessary can be incredibly effective at relieving that heavy sensation and giving you control and your quality of life back.
Your pessary is there to support your lifestyle, not restrict it. You may choose to wear it all the time, or use it only when you feel you need a little extra support, such as during exercise. Together, we will discuss your personal goals and match you with a care programme that fits seamlessly into your daily life.
How do I trial a pessary?
We require all patients to complete an initial assessment with our specialist pelvic health physiotherapist at Sulis Hospital prior to booking in for a pessary fitting. This ensures that we have optimised your pelvic floor strength, discussed lifestyle adjustments and that a pessary is a good option for you at this time.
We understand that pelvic health assessments can feel sensitive, and we will move entirely at your pace, and answer any queries you may have.
If you have been treated by a pelvic health physiotherapist elsewhere, we require a referral from them prior to booking a pessary fitting.
Do contact us at physioenquiries@sulishospital.com or call 01761 422 388 to discuss further.
The initial consultation
Your consultation: Time with an expert, to discuss the specific the symptoms bothering you most and how you are currently managing these symptoms.
Review your history: Time to review your medical history. To keep things simple for you, this will build upon the history we have already taken in a preview pelvic health assessment, or the details shared by your referring healthcare professional.
An internal examination: With your explicit, ongoing consent, your physiotherapist will perform a gently internal assessment to check your pelvic floor strength, coordination and timing.
What happens at a Pessary Fitting appointment?
A functional prolapse assessment: We will assess your prolapse (using a clinical tool called POP-Q scoring) to establish a baseline and determine the right style and size of device. This may involve a quick check while you are lying on your side and while standing up. This helps us see exactly how your tissues respond to gravity in everyday life.
Movement test: To make sure the device stays secure and feels completely comfortable, we will ask you to walk around the room, perform a few light movements, or even try a short run. Please wear comfortable clothing so you can move freely.
Standing check: When you return, we will do a standing check to ensure the pessary has responded beautifully to your physical activity. If the pessary is not comfortable or does not support your symptoms, with your consent, we can trial 1 or 2 more pessaries of differing sizes or styles.
Ongoing care and support: Once we find a pessary that feels comfortable and successfully eases your symptoms, we will decide together how you would prefer to manage it moving forward.
Taking your pessary home: in most cases, you can take it home with you straight away. If we need to order it from our specialist providers, it will generally arrive within just 1–2 days.
Self-management: If you feel comfortable doing so, we will patiently guide you through how to insert, remove, and clean your device independently at home.
Clinician management: If you prefer that a professional takes care of it, we are here for you. Clinical management simply involves coming back to see us every 3 to 6 months for as long as you use your pessary.
Keeping your GP informed: We believe in joined-up care, so we will send a supportive letter to your GP to let them know you have had a pessary fitted.
Your schedule for the first year
To carefully look after your vaginal tissue health and ensure you remain fully supported, we recommend the following return visits during your first year:
• Two weeks (to check the initial fit and ensure your comfort)
• Three months
• Six months
• Twelve months (moving to simple, annual check-ups after this)
Pessaries are widely recognised as safe, low-risk medical devices, but it is entirely natural to have questions about side effects. Some women experience a slight increase in clear or white vaginal discharge, and on rare occasions, there can be very mild bleeding or a rubbing sensation.
For women who are menopausal, we frequently recommend using a local oestrogen cream to help keep the vaginal tissues strong, supple, and comfortable enough to hold the device. While pessaries are not the perfect answer for everyone, around 85% of women experience great success with them and find they truly help restore their everyday confidence.
For a small number of women, a pessary might not produce the exact results they hoped for, and if that is the case, we will explore other supportive pathways together.
If you feel ready to see if a pessary could help you get your quality of life back, please give our team a call to discuss your first steps.
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