A pessary is a removable device that can be inserted into the vagina to support the uterus or the bladder, rather like a diaphragm. A pessary is used to relieve the ache from inadequately supported organs, known as prolapse. It can also help with urinary incontinence or support a uterus tipped into the wrong position, even during pregnancy. In some cases, a pessary serves as an alternative to a hysterectomy procedure.
Practice inserting and removing the pessary device while you are still in your doctor's office so that she can guide you. The advantage of the Gellhorn pessary is that it has a handle, in contrast to some pessaries which look like doughnuts. Rather than a doughnut hole, the Gellhorn pessary has a little non-rigid stem in the centre to facilitate insertion and removal. It extends harmlessly downward into the vagina after the pessary is inserted.
When you are ready to insert the pessary, wash your hands thoroughly and move into a suitable position. UCSF's Women's Continence Center suggests that you lie on your back, sit with your feet propped up or stand with one knee up and your foot on something like a chair or the rim of a bathtub. As much as you can, depending on the model, fold the Gellhorn pessary in half like a taco, with the stem inside the taco.
Hold the pessary in one hand with the open or stem side down, or toward your knees, and your finger remaining against the stem. Spread the lips of your vagina with the other hand. The folded side will touch you first; then, turn the pessary so its open or stem side is toward your rectum. Gently push the pessary as far into the vagina as it will go.
The pessary will open up toward the top of the vagina. With the Gellhorn pessary, you can let go of the edges of the folded disc and continue to press gently toward the inside on the stem to ensure the pessary is inserted as far as possible. If the device is inserted correctly, you should not feel any pressure or rubbing while wearing it.
Remove the pessary at least once a week for cleaning. Wash your hands thoroughly. Locate the stem of the Gellhorn pessary with two fingertips and gently pull. There is a tiny knob on the end of the stem to help. If you can feel the edges of the pessary, you can try folding them down toward the stem for easier removal. You will change the angle of the pessary a bit as you pull.
- Put some personal lubricant or vaginal oestrogen gel on the insertion edge or end of the folded device. You may prefer to remove the pessary at night and reinsert it in the morning for support when you are on your feet. Some pessaries can be left in during intercourse; check with your doctor before having intercourse while the pessary is inserted.
- If the pessary is uncomfortable or if you notice any unusual bleeding, call your physician. It often takes more than one try to get the size and shape of the pessary right for you. Do not hesitate to let your physician know if you need attention. Also check with her before douching or using other vaginal products.