A ring pessary is a small, flexible device, typically made of medical-grade silicone, inserted into the vagina to manage symptoms of pelvic organ prolapse or stress urinary incontinence. By elevating and stabilizing organs like the bladder, rectum, or uterus, the pessary helps restore a more normal anatomical position. The device offers a reversible alternative to surgery, providing relief from feelings of pressure, bulging, and involuntary urine leakage.
Normal Sensation and Expected Placement
The primary goal of a proper fitting is for the pessary to be unnoticeable during routine daily activities. If the device is correctly sized and positioned, you should not feel it resting inside your body, much like a well-placed tampon is not felt. Persistent discomfort, soreness, or a constant feeling of pressure often signifies that the pessary is too large or requires a different style.
The ring pessary is designed to sit high within the vaginal canal, creating support against the vaginal walls. The device should rest with one edge tucked behind the pubic bone and the opposite edge positioned high in the posterior fornix, often surrounding the cervix or vaginal vault. When checking with your finger, you may be able to lightly touch the lower edge or rim of the device. Feeling the edge confirms its presence in the proper high position and does not necessarily mean it is dislodged.
Techniques for Safe Self-Checking
Before attempting to check the position of your pessary, wash your hands thoroughly with soap and water to maintain hygiene and prevent the introduction of bacteria. Finding a comfortable position, such as squatting or standing with one foot elevated, can make reaching the device easier. Insert one finger into your vagina and gently sweep it around the interior circumference of the ring.
The purpose of this check is to confirm that the ring remains open, smooth, and is not folded or rotated sideways. A correctly placed ring will feel like a smooth, continuous circle that is still positioned high up in the canal. If you can hook your finger easily into the center of the ring, gently check the tension to ensure it has not slipped down closer to the vaginal opening. If the pessary is removable for cleaning, this check is a routine step to ensure proper reinsertion.
Indicators of Improper Fit and When to Seek Help
Any noticeable, persistent pain or discomfort is a strong sign that the pessary is not fitting correctly and requires attention. If the device has significantly slipped down into the lower third of the vagina or is expelled during physical activity or a bowel movement, it is likely too small or the support is inadequate. Also, be aware of any new or increased difficulty with urinating or emptying your bowels, as a displaced pessary can sometimes press on the urethra or rectum.
A change in vaginal discharge is another important indicator. While a slight increase in clear or creamy discharge is common, contact your healthcare provider if you notice a foul odor or a yellow or green color, which may signal a vaginal infection. Pink or bloody discharge is a warning sign, suggesting the pessary is rubbing against the vaginal wall and causing irritation or ulceration. If you experience any of these symptoms or are unable to remove a removable pessary, seek medical evaluation immediately.