OverviewNonsurgical treatment for vaginal prolapse involves use of a pessary. Pessaries are rubber devices, much like a diaphragm, that are placed inside the vagina to support the prolapsing portion of the vagina. Pessaries have been in use for a long time. Any patient with prolapse may be a candidate for a pessary.
If your doctor recommends use of a pessary, you will return to the clinic for a fitting to determine the best fitting size and shape. Your doctor will teach you how to place and remove the pessary. The pessary will arrive at your home about two weeks after it is ordered.
Pessaries may be worn for up to one month before changing them. But health-care providers usually recommend that they be removed weekly or every other week. Some women choose to remove them daily before bed.
Estrogen cream or a lubricant will facilitate placement of the pessary. Patients will return for follow-up exams at routine intervals to ensure that the device fits well and is functioning as it should.
ConsiderationsAny woman with vaginal prolapse may be considered for pessary placement. Some women may want to try a pessary while waiting for surgery. Others may want to use the pessary indefinitely. Women who have arthritis may have difficulty placing and removing the pessary.
EffectivenessPessary placement is highly effective, but does not treat the prolapse. Using a pessary simply allows patients to function with a vaginal prolapse.
If vaginal prolapse is not treated, it may progress to a higher stage, making treatment at that time more difficult.
UrgencyThere is not a true urgency, but doctors recommend that women have treatment within one year of diagnosis of prolapse