Pessary Fittings for Prolapse (POP)
Pelvic Organ Prolapse & Pessaries
Pelvic organ prolapse (POP) occurs when the pelvic organs—such as the bladder, uterus, or rectum—descend or shift from their normal position due to laxity in the supportive tissue around the organ. This condition can cause a range of symptoms, including pelvic pressure, urinary incontinence, difficulty with bowel movements, and vaginal bulging.
A pessary is a medical device designed to support the pelvic organs and help manage the symptoms of pelvic organ prolapse. It can provide relief and improve the quality of life for women who are experiencing POP, especially if surgery is not an immediate option or if a non-invasive approach is preferred.
What is a Pessary?
A pessary is a removable, flexible device that is inserted into the vagina to support the pelvic organs. Pessaries come in a variety of shapes and sizes, each designed to address different types of prolapse. Some are ring-shaped, while others may be more specialized, such as cubes, donuts, or even inflatable models.
Pessaries are non-surgical and can be an effective treatment option for managing prolapse symptoms. They offer both short-term relief and long-term support for women experiencing prolapse.
Benefits of Pessary Fitting
The right pessary can:
Relieve Symptoms: A properly fitted pessary can reduce pelvic pressure, decrease vaginal bulging, and improve urinary and bowel control.
Improve Quality of Life: By reducing discomfort and helping to restore normal pelvic organ function, a pessary can significantly improve day-to-day activities.
Non-Surgical Solution: For women who may not be ready for surgery or want to explore conservative treatment options, a pessary provides a non-invasive way to manage POP.
Adjustable and Customizable: Pessaries come in different shapes and sizes, allowing for a personalized fit that best addresses the individual needs of each woman.
Pessary Fitting Process
The fitting process is essential to ensure that the pessary is both comfortable and effective. Here’s what you can expect during a pessary fitting:
Consultation: You’ll start with a visit with Amanda Nayfield, DPT, WCS who is training in pessary fittings. She will discuss your symptoms, medical history, and treatment goals.
Pelvic Exam: The provider will perform a pelvic exam to assess the degree of prolapse, the condition of the pelvic floor muscles, and the anatomy of your vagina. This helps determine the right type and size of pessary.
Pessary Selection: Based on the findings from the exam, the provider will recommend a pessary type and size. It’s important to select a pessary that fits securely but comfortably.
Insertion and Adjustment: The healthcare provider will insert the pessary and guide you on how to properly place and remove it yourself. They will ensure it fits well and doesn’t cause discomfort. In some cases, multiple fittings may be necessary to achieve the best fit.
Follow-Up: After the pessary fitting, a follow-up appointment may be scheduled to ensure it is working as expected and to make any adjustments if needed. Regular follow-ups are important to check for any complications, such as vaginal irritation or difficulty with removal.
Why have a physical therapist fit a pessary?
Pessaries have traditionally been fitted by urologists or gynecologists, but in recent years, physical therapists have also received training to fit pessaries for individuals with prolapse. Pelvic health physical therapists specialize in addressing all the factors contributing to prolapse, including pelvic floor muscle strength, constipation, breathing strategies, movement patterns, and more. When fitting a pessary, we consider these factors and assess its effectiveness in real-life situations. For example, we may use gym equipment or a treadmill to simulate your daily activities and ensure the pessary is the best fit for your needs.
It's important to remember that the pessary is just one part of managing pelvic organ prolapse (POP) symptoms. We will continue to work with you after the fitting, addressing all contributing factors to provide comprehensive care.
