Tel: 07889 952759
Pessaries and pelvic organ prolapse
Pessaries are used to manage pelvic organ prolapse. Some women wear them all the time, while others only need them during physical activities for extra support. Think of them like a sports bra, but for your vagina—they go inside to support the prolapse and pelvic organs. Pessaries come in all sorts of shapes and sizes, just like vaginas, and they can really transform the management of your prolapse symptoms.
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Besides using pessaries, it's also important to strengthen and condition your pelvic floor muscles. This is a key part of Pelvic Health Physiotherapy. Good pelvic floor muscles are crucial because if they're weak or lax, your pessary is more likely to move around or even come out.
What will happen in a pessary fitting?
A pessary fitting appointment is takes up to 90 minutes and usually you will have had a Women’s Pelvic Health assessment with me (Jen Stroud) prior to discussing a pessary fitting appointment*. For pessary fitting, I may accept pessary referrals from other medical/healthcare professional who have examined your pelvic health and prolapse; this would be discussed on a case-by-case basis. I can also assess pessaries that have already been fitted by another provider, change them and re-fit as required.
The assessment will include:
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A short briefing on symptoms and current management. A discussion around your medical history and thorough history should have already taken place in a previous Pelvic Health assessment with me (Jen Stroud).
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Discussion indications and contraindications of pessary use.
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An alignment assessment – including movement such as walking, lifting, carrying.
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An internal examination to assess pelvic floor strength, co-ordination, and timing.
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Measurement of the prolapse – to determine the type and size of pessary but also to monitor the size of the prolapse over time. This may involve patient to be side lying and use of half a speculum.
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Discussion around a suitable type of pessary – Currently, I have ring and cube pessary fitting kits. Once a pessary type has been chosen, the fitting will take place.
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You'll then be asked to get and have a walk around the room, go outside and walk down the road, sometimes run if the pessary is for sporting use – weather dependent of course.
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A standing assessment will be performed to see how the pessary responds to gravity and functional movements.
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If the pessary is in a good position and comfortable, you'll be shown how to self-manage a pessary if you wish to – how to insert and remove. With some pessaries, you don’t have to self-manage and if you’d rather have them removed at intervals by me, that’s fine too.
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If the pessary is uncomfortable or moving position, then a trial of a different type or size will take place.
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Once the correct size and fit has been found, you can purchase that size and type of pessary right away (in most cases) to wear home.
I strongly recommend coming back to see me 2 weeks later for an assessment of the pessary, how you are getting on with it and a speculum examination to check your vaginal tissues after wearing the pessary. This can be done in addition to discussing other Physiotherapy treatments such as pelvic floor muscle training, functional strengthening exercises, breath work and anything else in your plan. Then it is important that your pessary and vaginal tissues are closely monitored and assessed at 3, 6 and 12 monthly intervals.
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About the appointment...
Wear comfortable clothing and perhaps wear trainers if you are hoping to use your pessary for sport or exercise. Also bring any pessaries that you have already had fitted if you'd like me to optimise/monitor an existing pessary.
My pessary fitting service costs £180 (excluding the pessary). Each pessary retails at around £50 depending on the type. Pessary fittings by a Physiotherapist are not covered by insurance companies. A £90 non-refundable deposit is required at the time of booking. I am happy to reschedule your appointment, but please provide at least 5 working days' notice. Deposits are not refundable if you choose to cancel your appointment. Follow Up appointments are £50 for 30 minutes or £60 for 45 minutes, and 60 minutes is £65. The length of follow up depends on whether you have reported any problems or want to discuss rehab and exercises too.
As I am a lone worker, I currently cannot offer a chaperone service. If you would like a chaperone for any intimate examination, you are entitled to one. Please note that while family and friends may accompany you to an appointment, they cannot act as a chaperone. If you wish to have a chaperone present, I will refer you to the nearest pessary fitting centre. See Ts and Cs for more details.
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Pessary fitting costs more than a standard Women's Pelvic Health appointment due to specialist training, extra cleaning with enzyme wash and autoclave, equipment costs and admin. Rest assured that I can discuss your case (with your permission) with an MDT of Urogynaecologists and other Pessary Fitting Physiotherapists to ensure you receive the best care and decision making. I will also write a report to your GP following your appointment for your NHS records.
*If you have recently been assessed by a Women's Pelvic Health Physiotherapist or Healthcare provider who have recommended you are assessed for a pessary, you may be eligible for a pessary fitting at your first appointment. I will discuss this via telephone call with potential clients and then contact your healthcare specialist for a handover. Based on this information, I will then determine if you can come in for a pessary fitting without an additional assessment.
If you have not yet seen a Women's Pelvic Health specialist, you will need to book an initial women's pelvic health assessment before a pessary fitting can be recommended.