About Incontinence - Treatment / Management Options - Pessary
Medical Reviewer: Catherine DuBeau, M.D.
A pessary is a small device made of rubber, plastic, or silicone, often shaped like a doughnut, that is inserted into the vagina to help support the pelvic floor. Pessaries are used to treat pelvic floor or organ prolapse, and incontinence that is felt to be related to existing prolapse. A health professional fits you for the product, and then you either learn to insert, remove and clean the pessary yourself, or you return to the doctor for periodic removal and cleaning.
Who?
Pessaries are used by women to help support the bladder and urethra. They are used by women with pelvic organ prolapse, including a cystocele, rectocele, and/or a dropped bladder or uterus.
The Pros
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Pessaries are completely removable if another treatment becomes available down the road.
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Pessary use carries less risk than surgery.
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When properly fit, a pessary is comfortable to wear.
The Cons
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Some women are uncomfortable with the thought of being fit for a pessary, inserting and removing the pessary on their own, or having a doctor insert or remove the pessary.
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Women who are sexually active need to remove the pessary before intercourse
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Infection can occur if the pessary is not removed and cleaned properly.
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Irritation can occur, especially in post-menopausal women (due to lack of estrogen and natural lubricant). However, this can usually be successfully treated with creams.
Catherine E. DuBeau, MD, is an Associate Professor of Medicine in the Section of Geriatrics at the University of Chicago . She has been actively engaged in teaching, management, and research regarding urinary incontinence in older persons for nearly 15 years. Her research focuses on quality of life impact and patient-centered outcomes. She has published numerous articles and book chapters on urinary incontinence and benign prostate disease in such publications as the Journal of the American Geriatrics Society, Journal of Urology, American Geriatric Society (AGS) Geriatric Review Syllabus, Cassell et al's Geriatric Medicine, Oxford Textbook of Geriatric Medicine, the on-line textbook UpToDate, and Chapple Multidisciplinary Management of Female Pelvic Floor Dysfunction. She was a member of the Urinary Incontinence Technical Subgroup of the National Committee for Quality Assurance that developed the Health Plan Employer Data and Information Set (HEDISâ) regarding urinary incontinence, and chaired the Evaluation Committee for developing the National Association for Continence (NAFC) Blueprint for Continence Care in Assisted Living. Dr. DuBeau most recently co-chaired the Frail Elderly Committee for the 2004 3rd International Consultation on Incontinence. She is a member of the Editorial Board of the Journal of the American Geriatrics Society, and in 2004 was awarded the AGS/NAFC Continence Care Champion Award. She is a dedicated teacher and lectures nationally and internationally on incontinence.
Page last modified 26 July 2009