Pessary Management for the General Gynecologist

Abstract

Pessaries are vaginal support devices that come in a variety of shapes and sizes. The purpose of this book chapter is to describe the indications, management, outcomes, and complications associated with pessaries for the general practitioner. A review of the pessary is provided. Information is based on primary literature, systematic reviews, and current expert opinion. Pessaries are most commonly used for pelvic organ prolapse and stress urinary incontinence. They are easy to place and have minimal serious side effects. The majority of women can be successfully fitted with a pessary in the outpatient setting. Pessaries improve vaginal bulge symptoms, urinary complaints, body image, and quality of life for women with pelvic floor disorders. Therefore, pessaries are safe and effective options for the management of pelvic floor disorders and should be offered to patients with pelvic organ prolapse and stress urinary incontinence. This review contains 5 tables, 6 figures and 30 references. Key Words: conservative management, Gellhorn pessary, pelvic organ prolapse (POP), ring pessary, SUI, urinary urgency, vaginal exam