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Ring Pessary

Ring pessary without support
Ring pessary with support
Urethra pessary with knob
Ring pessary with knob with or without support
 The ring pessary is the most common pessary prescribed by doctors.

The ring pessary is made from various materials such as PVC or Silicone and is available with or without a support.
Some have a steel spring inserted for stabilization. Ask your doctor if your ring pessary contains the steel spring.
If there is a steel spring inside your ring pessary please be aware as per the manufacture information for use (ask your doctor for a copy) this pessary should be removed if entering any Xray equipment.

Fitting of the ring pessary
It may take several attempts and sizes before you find one that is right for you.  Measuring for the ring pessary is done by your medical professional.
The ring pessary can be used up to six months and must then be discarded.
Some women are able to insert and remove the ring pessary themselves.

Tip if fitting the PVC pessary. Soak in warm water before fitting to soften the pessary for insertion.
Lubrication maybe used on all pessaries.

It is important to know that a well defined pubic notch is required to be ablet o retain the ring pessary.


Removal of the ring pessary
To remove a ring pessary, insert your index finger and feel for the notched area, make sure this notch is facing the introitus (opening to the vagina). Fold the pessary by notched area (so the sides without the notch come together) and gently bring pessary down in a folded position. Please be aware that not all maufacturers include the notch)
Lubrication maybe required for removal.
The majority of women find it near impossible to fold the pessary during removal, if this is you, then try using lots of lubrication try to then tilt the pessary so you are able to grab it with your middle finger and thumb with the notch facing the introitus then gently pull down, when it is part the way down it will be easier to compress the sides for removal.

Oestrogen cream use with pessaries
It is perfectly safe to use oestrogen cream. Apply the oestrogen cream first then wait around 20 minutes before inserting your pessary.

Sizes
Ring pessaries range from 50mm diameter to 100mm diameter. They increase in 5mm increments.

Treatment
The ring pessary is primarily used to treat slight descent of the uterus (grade 1-2) and a mild forms of incontinence.
Pelvic floor exercises are difficult to do with the ring pessary in situ.

Washing
The ring pessary can be washed in warm soapy water. It may also be sterilised or autoclaved but it is not necessary. NEVER try to sterilize your pessary in the microwave. It is preferable to let your pessary air dry as drying with a towel or paper may leave minute traces of material on the pessary which may cause infection in the vagina.

Ring with support.
The ring pessary with support helps keep a descending uterus in position.

Ring pessary with knob
The knob on the ring pessary is used to support the urethra in cases where the urthra has prolapsed. It supports the urethra in cases of stress incontinence.
The urethra pessary with knob contains a steel inner spring for stabilization. This pessary should be removed if passing through magnetic screening (airports) and for X-rays.

Which type is best for me?
Every woman is different and even though 2 women may have the same type of pelvic organ prolapse they may not necessarily both suit the same pessary. Pessaries are about trial and error and it may take several types and even sizes before you find the best fit for you. Always discuss the options with your
medical advisor.

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