Pessarium

Why do you need a pessary

A ring or pessary in the vagina can help with a prolapse of your bladder and uterus. The ring keeps the organs in place better. The ring sits in the vagina and rests on a layer of muscles (the pelvic floor). The uterus or vaginal wall (if you no longer have a uterus) hangs on the ring and no longer prolapses. The ring also pushes your urethra up a bit so that involuntary urine loss can improve. The ring must be changed occasionally, some women can do this themselves, if this is not possible the GP can do this.

How to measure and insert a pessary

• During vaginal examination, measure the distance between the posterior fornix and the back of the pubic bone by hand.
• Estimate the pessary diameter, usually between 65 and 90 mm.
• Heat the pessary with lukewarm water, for example, and squeeze the pessary together at the bottom with your thumb and index finger to form an oval shape
• Apply some lubricant
• Have the woman press lightly and spread the labia and insert the pessary slightly diagonally, avoiding contact with the urethra and clitoris.
• Then push the pessary further with one finger until it is past the pubic bone: the front now rests against the back of the pubic bone and the back lies in the posterior fornix
• A finger can still be inserted between the ring and the vaginal wall and the portio is located within the ring.
• Ask the patient if she can feel the pessary. If it is in the right place, the patient will not feel the pessary
• It may be too small and will fall out when straining, coughing or walking around. In that case, choose a 5-10 mm larger size.

Medische Vakhandel is a distributor of Profem pessaries for the Benelux.

Providing vaginal pessaries to support the pelvic floor in case of prolapse problems is a conservative treatment option that has been used successfully for many years and is currently making a comeback. The cost-effective range of these simple and uncomplicated aids, their good tolerability and, last but not least, the prospect of possibly being able to prevent prolapse and incontinence surgery contribute to this. The high-quality ProFem® pessaries are available in various designs and sizes and cover almost all indications in the treatment of pelvic floor prolapse and existing stress incontinence. Pessary therapy is a widely accepted, cost-effective and effective treatment for many pelvic floor disorders that is usually covered by health insurance.

Ring pessary
The ring pessary, available with or without a supporting membrane, is mainly used for mild first-degree uterine prolapse or cystocele.

Dish pessary
The Dish pessary, available with or without a supporting membrane, is used to relieve pressure from second- or third-degree uterine prolapse, cystocele or rectocele. This pessary can also relieve stress incontinence.

Firm ring
The new ring pessary in a firmer version is suitable for users who are looking for stronger support. It has the same indications as the ring with and without support.

Soft Ring
The new ring pessary in a softer version is suitable for patients who insert and remove the ring pessary themselves. It has the same indication range as the ring with and without support.

ProFem Sieve / Urethra pessary
The Ring pessary with button, available with or without supporting membrane, has the same indications as the ring and can also relieve stress incontinence.

Gellhorn pessary
The Gellhorn pessary with drains is used to relieve the symptoms of a cystocele or rectocele or a second or third degree uterine prolapse. The button of this pessary is available in two different lengths. The stem can be easily folded to facilitate insertion and removal.

Cubic pessary
The Cube pessary can be used to relieve the symptoms of a cystocele or rectocele, as well as a second or third degree uterine prolapse.
Due to its construction, the cube pessary exerts suction on the vaginal wall.

Donut pessary
The Donut pessary can be used to relieve the symptoms of a second or third degree uterine prolapse, a cystocele or rectocele. This pessary, which is often used by postmenopausal women, can be easily compressed for insertion and removal.