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Pelvic Organ Prolapse and Pessaries

Wesley S. Hilger

Wesley S. Hilger, M.D., FACOG

Sutter Medical Center, Sacramento

Sutter Independent Physicians

Surgery Center Division

Sutter Roseville Medical Center

Question:

I have prolapse that is made worse when I run. Running is something I need to be able to do, so what would you recommend? I've heard about pessaries - what are they?

Answer:

Prolapse of the pelvic organs should not be something that slows you down. In many cases relief can be obtained with a simple, noninvasive treatment called a pessary. A pessary is a silicon or rubber device that is designed to be placed within the vagina to support the weakened vaginal tissue that is resulting in the pelvic organ prolapse. Most women know what a diaphragm is but many are not aware of pessaries.

I joke with my patients that a pessary is like a diaphragm on steroids. A pessary is slightly bigger and stronger than a diaphragm so it can support the prolapsing vaginal tissues. Some descriptions of pessaries date back to 1500 BC and some consider it one of the oldest medical devices invented.

Needless to say pessaries work or else they would not continue to be in use. Modern pessaries come in various shapes and sizes. They require proper fitting for comfort and effective use. I tell patients that getting a good, properly fitting pessary is like getting a good pair of shoes. One must try several on, walk around, squat, and sit to insure that the pessary will not slip out while in use and that it is comfortable. A pessary should be easy to place and not felt while in use. When a pessary is in place you should not have to think about it, or the prolapse, so you can get on with the activities you want to do.

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