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The pessary is a device that is placed into the vagina to support the uterus and/or bladder and rectum. While there are many types and shapes, the most commonly used pessary is a firm ring that presses against the wall of the vagina and urethra to help decrease leakage and support a prolapsed vagina or uterus. The type and size of the pessary should be fitted to meet the needs of your problem and the requirements of your anatomy. A properly fitted pessary is not noticeable when it is in place.
If you have sensations of pressure or rubbing with continued wear of the pessary, or if you notice any unusual vaginal bleeding or spotting, call your health care provider immediately. It is not unusual to have to change the shape or size of the pessary after the initial fitting or even after continued wear. This is why it is important to keep the your regularly scheduled clinic appointments.
You may be aware of an increase in vaginal discharge or secretions with pessary use. However, the pessary is made of silicon rubber, and does not absorb odors or secretions. It can be kept in place for up to a week. The UCSF Women's Continence Center recommends only external cleansing. Do not douche or use vaginal products unless specifically provided by your health care provider.
Caring for a pessary is a skill easily learned. Pessaries can be left in place for up to a week, and removed for periodic easy cleansing. Some women choose to remove the pessary nightly before bed and replace it in the morning. It can be left in during intercourse if this is comfortable for you.
Inserting The Pessary
Wash your hands.
The notches inside the open ring and the openings in the ring-with-support are the flexible points. Grasp the device midway between these points and fold the pessary in half. The curved part should be facing the ceiling (like a taco). Put a small amount of water soluble lubricant (KY Jelly or other brand) on the insertion edge. Hold the folded pessary in one hand and spread the lips of your vagina with the other hand. Gently push the pessary as far back into the vagina as it will go. You can do this squatting, standing with one foot propped on the tub or toilet, or sitting with your feet propped up.
Removing The Pessary
Wash your hands.
Find the rim of the pessary just under the pubic bone at the front of your vagina. Locate the notch or opening and hook your finger under or over the rim. Tilt the pessary slightly, about a 30" angle, and gently pull down and out of the vagina. If you can fold the pessary somewhat, it will ease the removal. Bearing down as if you are having a bowel movement can help push the rim of the pessary forward so you can grasp it more easily.
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