Introduction:
Pelvic organ prolapse (POP) is a common condition that affects women, especially those who have had multiple vaginal deliveries, menopause, obesity, or chronic cough. It is a condition where the pelvic organs such as the bladder, uterus, or rectum lose their support and descend into the vaginal canal. This descent can cause discomfort, pain, urinary or fecal incontinence, and sexual dysfunction. Pessaries are one of the non-surgical treatments for POP, and this article will discuss pessaries, cystocele, and their relationship.
What is a Pessary?
A pessary is a medical device that is inserted into the vagina to provide structural support for the pelvic organs. It is made of silicone, rubber, or plastic, and comes in various shapes and sizes. The pessary works by lifting the prolapsed organs back to their original position, preventing further descent, and reducing the symptoms associated with POP.
Types of Pessaries:
There are different types of pessaries, and the choice of the pessary depends on the type and severity of the prolapse, the patient’s age and medical history, and the patient’s preference. Some of the common types of pessaries include:
Ring Pessary: A ring pessary is a donut-shaped device that is placed around the cervix. It is the most commonly used pessary and is suitable for mild to moderate prolapse.
Gellhorn Pessary: A Gellhorn pessary is shaped like a spoon and is used to support the uterus. It is suitable for women with moderate to severe prolapse.
Cube Pessary: A cube pessary is a square-shaped device that is used to support the bladder. It is suitable for women with a cystocele, which is a type of prolapse where the bladder descends into the vaginal canal.
Incontinence Ring Pessary: An incontinence ring pessary is a combination of a ring pessary and a knobbed pessary. It is suitable for women with both prolapse and urinary incontinence.
How to Insert a Pessary:
Inserting a pessary is a simple and painless procedure that can be done in the doctor’s office. The procedure involves the following steps:
Step 1: The patient should empty her bladder before the procedure to make the insertion easier.
Step 2: The doctor will examine the patient and determine the appropriate size and type of pessary.
Step 3: The doctor will apply a water-soluble lubricant to the pessary and insert it into the vagina.
Step 4: The doctor will make sure that the pessary is in the correct position and that the patient is comfortable.
Step 5: The doctor will show the patient how to remove and clean the pessary and schedule a follow-up appointment.
Complications of Pessary Use:
Pessaries are generally safe and well-tolerated, but like any medical device, they can cause complications. Some of the common complications associated with pessary use include:
Vaginal Discharge: Some women may experience vaginal discharge due to the presence of the pessary. This discharge is usually mild and can be managed with hygiene measures.
Vaginal Irritation: The pessary can cause vaginal irritation, itching, or redness. This can be managed with hygiene measures and the use of a water-soluble lubricant.
Pessary Displacement: In rare cases, the pessary can become displaced and move out of position. This can cause discomfort, pain, or bleeding. If this happens, the patient should contact her doctor immediately.
Pessary Allergy: Some women may be allergic to the material used to make the pessary. This can cause itching, redness, or swelling. If this happens, the patient should contact her doctor immediately.
Cystocele:
A cystocele is a type of pelvic organ prolapse where the bladder descends into the vaginal canal. It is a common condition that affects women, especially those who have had multiple vaginal deliveries, menopause, obesity, or chronic cough. A cystocele can cause discomfort, pain, urinary incontinence, and sexual dysfunction.
Symptoms of Cystocele:
The symptoms of cystocele vary depending on the severity of the prolapse. Some of the common symptoms include:
Feeling of pressure or fullness in the pelvis
Pain or discomfort during sex
Urinary incontinence or difficulty emptying the bladder
Frequent urinary tract infections
Constipation
Treatment of Cystocele:
The treatment of cystocele depends on the severity of the prolapse, the patient’s age and medical history, and the patient’s preference. Some of the common treatments for cystocele include:
Pelvic Floor Exercises: Pelvic floor exercises, also known as Kegel exercises, can help strengthen the muscles that support the bladder and reduce the symptoms of cystIntroduction:
Pelvic organ prolapse (POP) is a common condition in women with a prevalence increasing after menopause. The estimated lifetime risk of undergoing surgery for POP is approximately 12% in women. A cystocele is a type of POP that occurs when the bladder prolapses into the vaginal canal resulting in urinary symptoms. Pessaries are a non-surgical treatment option for women with POP, including cystoceles. This article will discuss the use of pessaries for cystocele treatment, their types, and their effectiveness.
What is a Pessary?
A pessary is a medical device that is inserted into the vagina to support the pelvic organs. It is a non-surgical treatment option for women with POP. Pessaries come in different shapes and sizes and are made of silicone, latex rubber, or plastic. They can be removed and cleaned by the patient, making them a convenient option for those who do not wish to undergo surgery.
Types of Pessaries:
There are many types of pessaries available, and the choice of pessary depends on the type and severity of POP, the patient’s age and medical history, and the patient’s preferences. The most commonly used pessaries for cystocele treatment are:
Ring Pessary: A ring pessary is a circular device that supports the vaginal walls and holds the pelvic organs in place. It is the most commonly used pessary for cystocele treatment. The ring pessary can be inserted and removed easily and does not require any special skills. It is available in different sizes and can be adjusted to fit the patient’s needs.
Gellhorn Pessary: A Gellhorn pessary is a solid, curved device that is designed to lift the uterus and the vaginal walls. It is usually used for women with severe POP or a large cystocele. The Gellhorn pessary is inserted and removed by a healthcare provider and requires some training to use.
Cube Pessary: A cube pessary is a square-shaped device that supports the vaginal walls and the pelvic organs. It is used for women with mild to moderate POP or a small cystocele. The cube pessary is easy to insert and remove and can be adjusted to fit the patient’s needs.
Donut Pessary: A donut pessary is a circular device with a hole in the center that is designed to support the vaginal walls and the pelvic organs. It is used for women with mild to moderate POP or a small cystocele. The donut pessary is easy to insert and remove and can be adjusted to fit the patient’s needs.
How does a Pessary work?
A pessary works by supporting the pelvic organs and preventing them from prolapsing into the vaginal canal. It also helps to restore the normal anatomy of the pelvic floor and improve urinary symptoms. The pessary is inserted into the vagina and can be adjusted to fit the patient’s needs. The patient can remove and clean the pessary as needed.
Effectiveness of Pessaries:
Pessaries are an effective treatment option for women with POP, including cystoceles. Studies have shown that pessaries can improve urinary symptoms, quality of life, and sexual function in women with POP. The effectiveness of pessaries depends on the type and severity of POP, the patient’s age and medical history, and the patient’s preferences. Some women may need to try different types of pessaries before finding the one that works best for them.
Side Effects of Pessaries:
Pessaries are generally safe and well-tolerated by most women. However, some women may experience side effects, such as vaginal irritation, discharge, or discomfort. In rare cases, the pessary may cause an ulcer or infection in the vaginal wall. Women who experience any side effects should contact their healthcare provider.
Conclusion:
Pessaries are a non-surgical treatment option for women with POP, including cystoceles. They come in different shapes and sizes and can be adjusted to fit the patient’s needs. Pessaries are an effective treatment option for improving urinary symptoms, quality of life, and sexual function in women with POP. However, the choice of pessary depends on the type and severity of POP, the patient’s age and medical history, and the patient’s preferences. Women who experience any side effects should contact their healthcare provider.
