It is estimated that 1 in 10 women over fifty can be affected by pelvic organ prolapse (POP). It happens due to weakening of the ligaments and muscles of the pelvic floor that support the pelvic organs, (uterus, bladder, and rectum). A prolapse occurs when these organs bulge from their natural position into the vagina.
A prolapse can feel like a lump in the vagina, sometimes it can be felt or seen outside the vagina. Common symptoms include vaginal heaviness or discomfort, discomfort during sexual intercourse and a change to how you empty your bladder or bowel.
A vaginal pessary is a plastic or silicone device that fits into the vagina and supports the pelvic organs. It is suitable for most people and can be a very effective way to manage symptoms. There are many shapes and sizes of vaginal pessaries, and it can take more than one attempt to identify the correct one. Vaginal pessaries do need to be changed or removed, cleaned, and reinserted every 4-6 months. A health professional can change the vaginal pessary, or you may wish to learn how to do this yourself.
You can choose to use a vaginal pessary as a long- term treatment or short-term if you plan to have more children or may wish to have surgery later.
Vaginal pessaries do not usually cause any problems but those we know of include vaginal discharge, vaginal bleeding, infection, ulceration and very rarely the pessary may displace and get stuck.
It is important that when you use a vaginal pessary to avoid getting constipated as straining to open your bowels can contribute to it moving or falling out.
Alternative treatments for prolapse include lifestyle changes (weight loss, stopping smoking, avoiding constipation, avoiding heavy lifting, managing any long-standing cough, and avoiding physical activity that impacts on the pelvic floor), pelvic floor physiotherapy and surgery.
Our Urogynaecology service provides both consultant and nurse led clinics which offer assessment and treatment for POP.
Our nurse led clinics offer timely follow-up to all patients who choose to have a vaginal pessary and will also teach patients how to remove and re-insert the pessaries themselves. We have emergency appointments to see patients who may be experiencing problems associated with the vaginal pessary.
If you believe you may have a prolapse and your symptoms are affecting your daily activities, you can speak to your GP to see if you need to be referred to our service for further assessment.
Katie Booth
Urogynaecology Nurse Practioner