Pessary
Pessaries come in different shapes and sizes, so it is important that individuals be fitted for them by health care professionals to avoid any complications.
[1] However, there are a few instances and circumstances that allow pessaries to be purchased without a prescription or without seeking help from a health care professional.
[3] The term 'pessary' itself, is derived from the Ancient Greek word 'pessós', meaning round stone used for games.
[4][5] Pessaries are even mentioned in the oldest surviving copy of the Greek medical text, Hippocratic Oath, as something that physicians should never administer for the purposes of an abortion: "Similarly I will not give to a woman a pessary to cause abortion.
For example, Greek physicians Hippocrates and Soranus described inserting half of a pomegranate into the vagina to treat prolapse.
[5] For instance, in the late 1500s, Ambroise Paré was described as making oval pessaries from hammered brass and waxed cork.
[3] Stress urinary incontinence is leakage of urine that is caused by sudden pressure on the bladder.
It occurs during activities that increase the amount of pressure on the bladder such as coughing, sneezing, laughing, and exercising.
[8] The pressure causes opening of the sphincter muscles which usually help prevent urine leakage.
[8] Pessaries are considered a safe non-surgical treatment option for stress urinary incontinence as it can control the urine leakage by pushing the urethra closed.
[8][9] Some additional uses for pessaries are for an incarcerated uterus, prevention of preterm birth and an incompetent cervix.
[3][10] In early pregnancy the uterus can be displaced, which can lead to pain and rectal and urinary complications.
Currently, the use of pessaries to help prevent preterm birth is an ongoing area of research.
[12] Pessaries are most commonly used for pelvic organ prolapse and considered a good treatment option for women who need or desire non-surgical management or future pregnancy.
[5] These are often used as a first-line treatment and used for earlier stage prolapse since individuals can easily insert and remove them on their own without a doctor's help.
These types of pessaries need to be fitted by a health care professional to ensure proper size.
[17] Pessaries can also be used in a similar way to help induce labor for women who have overdue expected delivery dates or who experience premature rupture of membranes.
Prostaglandins are usually the medication used in these kinds of pessaries in order to relax the cervix and promote contractions.
It is recommended for anyone attempting this form of contraception to be fitted for the correct size by a trained health care professional.
[21] When pessaries are used correctly, they are tolerated well for pelvic organ prolapse or stress urinary incontinence.
[12] Vaginal discharge and odor may be associated with bacterial vaginosis, characterized by an overgrowth of naturally occurring bacteria in the vagina.
[23] To prevent these side effects, individuals can be fitted properly for their pessaries and undergo routine follow-up visits with their health care professionals to ensure the individual has the correct pessary size and no other complications.
