Pessary Clinic (Newmarket Only)
Pessaries are a tool to help with prolapse
Sometimes called a “sports bra for pelvic organs”, a pessary is a device that fits into the vagina to help support the prolapse of an organ – this can include the uterus, the bladder or the rectum (the bottom of the bowel).
Prolapse can develop when an organ loses its ligamentous support, causing it to push down into the vagina – this can be caused by childbirth, aging, following pelvic surgery – there are so many reasons. Prolapse can even be caused by chronic coughing or straining. Prolapse can be fixed with surgery, or a pessary can be inserted to support the prolapse and help relieve the symptoms of prolapse.
Please note – currently we are only able to dispense pessaries in our Newmarket clinic. We are hoping to bring this service to our Toronto clinic soon.
Prolapse care: Pessary or Surgery?
Many of our pelvic floor patients present with symptoms of prolapse.
You may have had that moment where you feel like things just aren’t quite the same “down there”. You may feel a feeling of fullness in your vagina or around your vulva, or perhaps you feel something that wasn’t there before. That might be a propalse. The best way to know is to have it assessed by one of our pelvic floor physios and/or your OB/midwife or your GP.
The good news is that there are treatment options. Surgery is definitely an option for prolapse, but if you’re not inclined to trying pelvic surgery, a pessary might be the right solution for you. They’re flexible, they can be removed, they are safe and easy to use, and they can help with the symptoms that accompany your prolapse.
What is a pessary?
Pessaries are semi-flexible devices that are inserted into the vagina to help support your prolapse. They come in many shapes and sizes (just like we do!), so they’re very customizable to your own specific anatomy. They can be removed to be washed and they’re easy to re-insert. They shouldn’t get in the way of your day-to-day life.
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You can have your first appointment to get fitted for the pessary without a doctor’s note, but your doctor will need to do a vaginal exam and provide you with a prescription for a pessary before we can dispense it to you for you to take home.
If you see your doctor before you come for your first pessary appointment, just make sure that they provide you with a prescription for the pessary and bring it with you to the appointment so that we can dispense it (and so you can get it covered by insurance, if you have it!).
Don’t worry if you haven’t seen your doctor first. You can still book come in for an appointment. Our pelvic physios will examine you give you their recommendations, and if a pessary is indicated, they can send you back to your doctor for that prescription. Once you’ve got your prescription, you would return to get it fitted and take it home.
As long as you have a doctor’s note for a pessary, it’s very likely that your insurance will cover it as a medical device. Call your insurance just to be sure.
Yes, and we encourage it. Sometimes our patients just feel like things aren’t quite right with their vagina and they need a second opinion. We can provide that for you and give you guidance for next steps.
The decision about which type of pessary you should use really depends on the type of prolapse and its symptoms. The pessary will be properly fitted by one of Oona’s pelvic floor physiotherapists, and it can take a few tries to get the right one. We want to make sure you’ve got the right fit!
After the first fitting you’ll need to return in one week to make sure it’s still sitting in the right place and fitting well. After that, we recommend a follow-up appointment every few months to check on it. From time to time, we may need to swap it out for a pessary with a different shape or size.
It’s very important that you follow the instructions that you are given to care for your pessary. Many pessaries can be removed at night and replaced in the morning, or as directed. Often it is removed weekly.
After removal, wash the pessary with soap and water, rinse it off, and be sure to clean any holes or crevices. Dry the pessary and store it overnight and re-insert in the morning. Never use chemicals to clean your pessary, and make sure to keep your follow-up appointments.
Most of our clients find that they have minimal or no side-effects with their pessaries.
You may notice that your vaginal discharge changes a bit – it could become heavier or develop an odour. Vaginal irritation is possible – women past menopause may find it helpful to use an estrogen cream to make it more comfortable.
If your vaginal discharge smells bad, or if you have lots of discharge or blood, you immediately remove the pessary and contact your healthcare provider.
You may be able to use a pessary during pregnancy, but it must be fitted by your OB. Our physiotherapists are not able to fit pessaries during pregnancy.
Most pessary manufacturers suggest that your pessary should be replaced about once a year. It’s very common for it to become slightly discolored over time – this is normal, and not a problem. However, if it becomes deformed at all or starts to develop tiny cracks, come on in for us to check it out and get you fitted for a new one.
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Oona works with insurance companies to do online billing for treatments, whenever possible. Simply ask if your insurance company is compliant when you book your appointment.