Pessaries are used in the management of pelvic organ prolapse. Some women wear them all the time and some women just need a little extra support when doing sport (like using a sports bra). Like vaginas, pessaries come in different shapes and sizes and there is no one size fits all. We aim to find the right pessary for you.
Even with a pessary, strengthening and conditioning of the pelvic floor muscles continues to be very important as your pessary can fall down/out. Help and advice about pelvic floor exercises will form part of your treatment.
What happens before a Pessary Fitting appointment?
Before you book in for Pessary Fitting you will first need to book a Women’s Health Assessment with our Pelvic Health Specialist. Click here to read about the Women’s Health Assessment and to book online.
If you’ve already seen a medical professional regarding a pessary fitting or have had any investigations relating to your pelvic health then you may be eligible to attend a pessary fitting on your first appointment. If this is the case please contact us and we can assess which appointment is most appropriate for you in the first instance.
What happens at a Pessary Fitting appointment?
An appointment with our Pelvic Health Specialist can be between 1 – 1.5 hours long and will include:
- A recap on your medical history, symptoms and current management.
- Discuss/confirm whether the use of a pessary is right for you (indications and contraindications).
- An alignment assessment – including movement such as walking, lifting, carrying.
- Breathing assessment – how the ribs, diaphragm, stomach move in conjunction with one another.
- Abdominal separation assessment.
- An internal examination to assess pelvic floor strength, co-ordination and timing.
- Measurement of the prolapse – helpful when choosing the appropriate pessary but gives a baseline measurement to compare with in the future. This may involve being side lying and use of half a speculum.
- Discuss which pessary would be suitable and a fitting will take place.
- You’ll then be asked to get and have a walk around the room, go outside and walk down the road, sometimes run if the pessary is for sporting use.
- A standing assessment is carried out to see where the pessary is sitting in a functional position.
- If the pessary is in a good position and comfortable, you’ll be shown how to self-manage a pessary – how to insert and remove.
- If the pessary is not sitting in a satisfactory position, then you can trial a different size and in some cases a different type.
We recommend coming back to clinic two weeks later for a follow up to discuss how things are doing, check the pessary and answer any questions. Pelvic floor programme’s will be adjusted and progressed if needed. Follow up appointments are usually booked at 3, 6 and 12 months.
What do I need to bring to the appointment?
If you participate in any active training or sport, then please bring a pair of trainers to the session as your physio may carry out relevant testing to your activity.
This appointment is best to be completed when you are not menstruating, so please take this into consideration when booking an appointment. If you have already made an appointment but you now realise you will be menstruating, please contact us as soon as possible to re-arrange for a more convenient time.
Our pessary fitting service costs £255 (which includes the costs of your pessary). Please note that pessary fittings are not covered by insurance companies. Payment for the appointment must be made at the time of booking. Our cancellation notice period for pessary fittings is 2 working days.
If you cancel your appointment less than 48 hours before you are due to attend you will be charged a cancellation fee.