When trialing pessaries, women sometimes ask, “How do I know if the pessary is working?”. Pessaries do not directly fix prolapses or the mechanical breakdown behind stress urinary incontinence; rather, their purpose is to manage the symptoms associated with these conditions. For this reason, it is very easy to tell if a pessary is working- if it reduces your unwanted symptoms and does not create other unwanted symptoms, it is working! When I am fitting a woman for a pessary, I have certain questions I ask my client and tests I do to determine if the pessary is a correct fit. See below for the characteristics of a successfully fitted pessary versus those of an ill-fitting pessary.
Correct Fitting
- No or very minimal, non-painful sensation of the pessary once inserted
- Reduced or abolished feeling of heaviness, pressure or bulge
- Reduced or abolished urinary incontinence
- Reduced or abolished pain associated with prolapse
- Improved urine and stool evacuation
- Improved sexual function
- Better overall quality of life
Incorrect Fitting/Reconsider use of Pessary
- No change in symptoms of heaviness, pressure or bulging
- No change in frequency or amount of stress urinary incontinence
- Falls out or repeatedly slips down to an uncomfortable position
- Unusual discharge (odour, color, quantity)
- Burning with urination
- Vaginal itching
- Blood on the pessary or vaginal bleeding
- Not sure if it is positioned well (just doesn’t feel right)
- Discomfort or pain at rest or with effort
- Pain urinating or defecating
- Urinary or bowel retention or more difficult voiding or evacuation
If you have been fitted for a pessary and experience any of the characteristics in the “incorrect fitting” category, see your doctor and notify your fitting health care professional. You might need a different size or style of pessary, vaginal moisturizer or topical estrogen, or other treatment before continuing pessary use.
The information in this blog is provided as an information resource only and should not be used as a substitute for seeking personalized direction from your overseeing physician. Please consult your healthcare team before making any decisions about your pessary treatment plan, which is unique to you and your overall health. Toronto Pessary Clinic expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this blog.