PESSARY FITTING  

A women’s health specialist is a chartered therapist that has specialised training in pelvic health. A ‘normal’ physio will treat movement issues related to all your joints and muscles, a women’s health specialist assesses and treats problems related to your pelvis (pubic symphysis or sacro-iliac joints), abdominal wall, vulva, vagina, uterus, bladder and bowel as well.

  • 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, imagine it like using a sports bra. Pessaries come in lots of different shapes and sizes as do vaginas and are there to help relieve pelvic organ prolapse symptoms.

    Pessaries are another management tool along with strengthening and conditioning of the pelvic floor muscles. A good pelvic floor muscle function is still very important as your pessary can fall down/out.

What happens during an appointment?

An appointment with one of our team can be between 1-1.5hours long and will include:

  • A short briefing on symptoms and current management. A discussion around your medical history should have already taken place.
  • Discuss indications and contra-indications of pessary use.
  • 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 patient to be side lying and use of a speculum.
  • Discuss which pessary would be suitable and then the fitting will begin.
  • 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 will be shown how to self-manage the pessary – how to insert and remove.
  • If the pessary is not sitting in a satisfactory position, then your physio will trial a different size and in some cases a different type.

Your Physio will recommend that you come back to clinic 2 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.