Pessar

A pessary is a medical device placed into the vagina to support pelvic organs. It is most commonly used to treat pelvic organ prolapse, such as uterine descent, cystocele, or rectocele, and may also help with certain forms of urinary incontinence. In pregnancy, a cervical pessary may be used in selected cases to reduce the risk of preterm birth by providing cervical support.

Pessaries come in several shapes and are typically made of silicone or other medical-grade polymers. The most common form is the ring pessary, which surrounds the cervix or vaginal walls to provide lift and support. Other shapes include donut, Gellhorn, and shelf pessaries, each designed for different anatomies. A cervical pessary is specifically fitted around the cervix to support it within the vaginal canal.

Fitting is performed by a clinician during a pelvic examination. The size and shape are chosen to balance stability with comfort, and improper fit can cause irritation or erosion. Many pessaries are removable and reusable and can be cleaned by the patient or at follow-up visits; some require periodic professional maintenance or replacement. They can often be worn for extended periods, with regular check-ups to monitor fit and vaginal health.

Risks and complications are generally uncommon but can include vaginal discharge, odor, irritation, ulcers, or pressure sores if the device is ill-fitting or left in place too long. Infections or bleeding are rare. Pessaries are not contraception and do not protect against sexually transmitted infections. They are one option among non-surgical treatments for prolapse or pregnancy-associated cervical issues, with surgery or pelvic floor therapies as alternatives.