A pessary is a soft, removable device, typically made of silicone, designed for insertion into the vagina. Its primary purpose is to provide support for pelvic organs that may have shifted from their natural position, a condition known as pelvic organ prolapse. This device also helps manage symptoms of stress urinary incontinence, such as involuntary urine leakage during activities like coughing or exercise. Pessaries offer a non-surgical option for managing these conditions, aiming to improve comfort and quality of life.
Understanding Typical Wear Times
The duration a pessary can remain in place varies significantly, depending on the specific type of pessary, individual patient needs, and healthcare provider recommendations. Some pessaries, particularly those for more severe prolapse like the cube pessary, may require daily removal for cleaning. Other common types, such as ring pessaries, can often be left in for longer periods, ranging from a week to several months. Some guidelines suggest certain pessaries can safely stay inserted for up to three to six months, or even four to twelve weeks, before needing professional removal and cleaning.
Patients who can self-manage their pessary often choose to remove and clean it more frequently, such as nightly or weekly, allowing for greater personal control and hygiene. This self-management approach has shown comparable quality of life outcomes and potentially fewer complications compared to clinic-based care, where healthcare providers typically remove and clean the device every few months. The decision on wear time should always be a collaborative one between the patient and their healthcare provider, tailored to individual comfort and vaginal health.
Routine Cleaning and Maintenance
Regular cleaning of a pessary is crucial for preventing complications and maintaining vaginal health. If a pessary can be self-removed, it should be taken out and cleaned daily or weekly, as advised by a healthcare provider. The cleaning process typically involves washing the device with mild, unscented soap and warm water.
After washing, the pessary should be thoroughly rinsed to remove all soap residue, then dried completely before reinsertion. Maintaining good hand hygiene by washing hands thoroughly before touching the pessary or vaginal area is important to prevent introducing unwanted bacteria. For individuals unable to remove their pessary, clinic visits are scheduled every few months for professional cleaning and examination.
Recognizing When to Seek Medical Advice
It is important for individuals using a pessary to be aware of certain signs that may indicate a need for prompt medical attention. Any unusual vaginal discharge, especially if foul-smelling, yellow, or green, should be reported to a healthcare provider. Persistent vaginal odor is another symptom that warrants evaluation, as it could signal an infection.
Discomfort or pain while the pessary is in place, or the development of pink or bloody discharge, suggests that the pessary may not fit correctly or could be causing irritation to the vaginal walls. Other symptoms, such as difficulty with urination or bowel movements, or the pessary repeatedly falling out, also indicate that the device may need adjustment or refitting. Prompt consultation with a healthcare professional can address these concerns and help prevent further complications.
Risks of Extended Wear
Leaving a pessary in for too long without proper cleaning or medical supervision can lead to several complications. One common issue is an increase in vaginal discharge, which is the body’s natural response to a foreign object, but it can become abnormal if foul-smelling or discolored. Prolonged wear can also increase the risk of vaginal infections, such as bacterial vaginosis, or urinary tract infections.
More serious complications include vaginal ulcerations or tissue erosion, which occur when the pessary rubs against the vaginal wall, leading to irritation and potential breakdown of tissue. In very rare cases, if a pessary is neglected for an extended period, it can become embedded in the vaginal wall, making removal difficult, or lead to the formation of a fistula, an abnormal connection between organs. Adhering to recommended wear times and follow-up schedules is important to minimize these potential risks.