How Do You Put in a Pessary? A Comprehensive Guide
How do you put in a pessary is a common question among women who have been advised to use this medical device to manage pelvic organ prolapse or urinary incontinence. Pessaries are removable devices inserted into the vagina to support the pelvic organs and help alleviate symptoms associated with prolapse or incontinence. While the idea of inserting a pessary might seem daunting at first, with proper instructions and practice, most women find it manageable and comfortable. This guide aims to provide detailed, step-by-step information to help you confidently and safely insert a pessary at home or in a clinical setting.
Understanding Pessaries and Their Purpose
What is a Pessary?
A pessary is a medical device made of silicone, rubber, or plastic designed to support the bladder, uterus, or rectum when these organs sag due to weakened pelvic muscles. Pessaries come in various shapes and sizes, including ring, donut, sphere, or other custom-fit designs. Your healthcare provider will recommend the most suitable type based on your specific condition.
Why Use a Pessary?
- To manage pelvic organ prolapse (such as cystocele, rectocele, or uterine prolapse)
- To alleviate urinary incontinence symptoms
- As an alternative to surgery or while awaiting surgical intervention
- To improve quality of life by reducing discomfort and improving support
Preparing to Insert a Pessary
Consult Your Healthcare Provider
Before attempting to insert a pessary on your own, it’s essential to have a thorough consultation with your healthcare provider. They will determine the appropriate type and size of pessary and demonstrate the correct insertion technique. Additionally, they will provide guidance on cleaning, maintenance, and when to seek medical advice.
Gather the Necessary Supplies
Ensure you have the following items ready:
- Appropriate pessary (as prescribed by your healthcare provider)
- Water-based lubricant (silicone-based lubricants are generally not recommended)
- Mirror (optional but helpful for visual guidance)
- Clean hands and, if desired, disposable gloves
Step-by-Step Guide to Inserting a Pessary
1. Wash Your Hands Thoroughly
Begin by washing your hands with soap and water to minimize the risk of infection. Dry your hands completely before handling the pessary.
2. Find a Comfortable Position
Choose a position that allows easy access and comfort. Common positions include:
- Sitting on the toilet or a chair with knees apart
- Standing with one foot elevated on a stool
- Lying on your back with knees bent and legs apart
Experiment to find the position that works best for you. Using a mirror can help with visibility if needed.
3. Apply Lubricant to the Pessary
Use a water-based lubricant to coat the entire surface of the pessary. This reduces discomfort during insertion and helps it glide smoothly into place.
4. Hold the Pessary Correctly
Hold the pessary with your fingers, ensuring the shape is oriented correctly. For ring-shaped pessaries, the opening should face downward or as instructed by your healthcare provider.
5. Insert the Pessary
- Gently separate your labia with your fingers.
- Slowly and carefully insert the pessary into your vagina, aiming for the back wall.
- If using a ring pessary, press the sides together to make it narrower, then insert it into the vagina. Once inside, release it so it sits comfortably against the vaginal walls.
- For other types, follow your healthcare provider’s instructions for the specific device.
6. Ensure Proper Placement
Once inserted, the pessary should sit comfortably and support your pelvic organs. It should not cause pain or discomfort. You can check placement by gently pressing on your abdomen or using your fingers to feel if the pessary is in the correct position.
Tips for Comfortable Insertion and Removal
Practicing and Patience
It may take a few attempts to become comfortable with inserting and removing your pessary. Practice in a private, relaxed environment, and don’t rush the process. If you experience persistent difficulty or discomfort, consult your healthcare provider.
Using Lubricant Effectively
Applying enough water-based lubricant ensures smoother insertion and reduces discomfort. Avoid using oil-based lubricants, as they can degrade silicone pessaries and increase the risk of irritation.
Timing of Insertion and Removal
- Most women remove and clean their pessary daily or weekly, as recommended by their healthcare provider.
- Follow your provider’s instructions for how often to remove, clean, and reinsert the pessary.
- Remove the pessary if you experience pain, bleeding, or discomfort, and consult your healthcare provider.
Removing the Pessary
Steps for Safe Removal
- Wash your hands thoroughly.
- Find a comfortable position similar to insertion.
- Gently insert your fingers into your vagina to locate the pessary.
- Carefully grip the pessary and gently pull it out, being cautious not to cause discomfort or injury.
- Clean the pessary with mild soap and water if recommended, then store it in a clean container until the next use.
When to Seek Medical Advice
If you experience persistent pain, bleeding, foul odor, or difficulty removing the pessary, contact your healthcare provider promptly. Regular follow-up appointments are essential to ensure the device fits correctly and to prevent complications.
Additional Tips and Considerations
- Carry out the insertion and removal process in a hygienic environment to prevent infections.
- Keep a record of your insertion and removal schedule, especially if you have to monitor symptoms or notify your healthcare provider.
- Be patient and gentle during the process; do not force the pessary if it feels resistant.
- Wear comfortable, breathable clothing to help you manage the device discreetly and comfortably.
Conclusion
Knowing how do you put in a pessary confidently is an empowering step toward managing pelvic health conditions effectively. With proper training from your healthcare provider, adequate preparation, and patience, inserting a pessary can become a routine part of your self-care. Remember, regular follow-ups and communication with your healthcare team are vital to ensure ongoing comfort, proper fit, and health safety. If you experience any issues or uncertainties, do not hesitate to seek professional guidance to optimize your experience with pessary use.
Frequently Asked Questions
What are the general steps to insert a pessary correctly?
To insert a pessary, wash your hands thoroughly, lie down comfortably, gently fold the pessary if needed, and carefully insert it into the vagina towards the lower back, ensuring it sits properly around the cervix or inside the vaginal canal as directed by your healthcare provider.
How do I ensure that the pessary is inserted correctly and comfortably?
Make sure the pessary is fully inside the vaginal canal and positioned as instructed by your healthcare provider. Relax your muscles, breathe slowly, and take your time during insertion to reduce discomfort. If you feel pain or discomfort, remove and try again or contact your provider.
Are there any tips for inserting a pessary for the first time?
Yes, relax and take deep breaths, use plenty of water-based lubricant on the pessary, lie down in a comfortable position such as lying back with knees bent, and go slowly. Watching instructional videos or consulting your healthcare provider can also help build confidence.
How often should I remove and clean my pessary?
Typically, a pessary should be removed and cleaned as advised by your healthcare provider, often once a day or weekly. Follow your provider’s specific instructions for cleaning and schedule regular check-ups to ensure proper fit and comfort.
Can I wear a pessary while exercising or during daily activities?
Yes, most women can wear a pessary during daily activities and exercise. However, if you experience discomfort or unusual symptoms, consult your healthcare provider to ensure proper placement and fit.
What should I do if I experience discomfort or pain after inserting a pessary?
If you experience discomfort or pain, remove the pessary carefully and contact your healthcare provider for guidance. Do not force it in or leave it in if it causes pain, as it may indicate incorrect placement or other issues.
Are there any precautions I should take when inserting a pessary?
Yes, always wash your hands before handling the pessary, use water-based lubricant if needed, follow your healthcare provider’s instructions, and avoid inserting the pessary if you're experiencing symptoms like bleeding or unusual discharge. Regular follow-up appointments are also important.
