Selection and application of the urogynecological pessary (without the cost of the pessary)

Selection And Application Of The Urogynecological Pessary (Without The Cost Of The Pessary)

We remind you that independent interpretation of the results is unacceptable, the information provided below is for reference purposes only.

A pessary is a medical device used to support or reposition the pelvic organs, such as the uterus, bladder, or rectum, in cases of pelvic organ prolapse. Pelvic organ prolapse is a condition where the pelvic organs bulge into or out of the vagina due to weakened pelvic floor muscles and ligaments.

Types of Urogynecological Pessaries

There are various types of pessaries available, each designed for specific purposes and anatomical fit. Some common types include:

• Ring pessary
• Gellhorn pessary
• Cube pessary
• Donut pessary
• Inflatable pessary

The choice of pessary type depends on factors such as the degree and type of prolapse, patient comfort, and physician preference.

Application and Fitting of Pessaries

The application and fitting of a pessary should be performed by a qualified healthcare professional, typically a urogynecologist or a trained nurse practitioner.

The process involves the following steps:

1. Patient evaluation and assessment of the prolapse type and severity.
2. Selection of the appropriate pessary type and size based on the evaluation.
3. Proper fitting and insertion of the pessary into the vaginal canal.
4. Adjustment and positioning of the pessary for optimal support and comfort.
5. Patient education on proper pessary care, hygiene, and removal/reinsertion techniques.

Regular follow-up visits are necessary to monitor the effectiveness and potential complications of pessary use.

Proper pessary selection and application can effectively manage pelvic organ prolapse and improve the patient's quality of life. However, it is crucial to follow the healthcare provider's instructions and attend regular follow-up appointments to ensure safe and effective use.

Role of Urogynecological Pessary

The urogynecological pessary plays a crucial role in the management of pelvic organ prolapse and stress urinary incontinence in women. It is a non-surgical, conservative approach that helps support and reposition the prolapsed organs, such as the uterus, vagina, or bladder, back into their normal anatomical position. The pessary can provide symptomatic relief and improve quality of life for patients who are not candidates for or wish to delay surgical intervention.

Indications for Urogynecological Pessary Application

The application of a urogynecological pessary may be indicated in the following cases:

• Pelvic organ prolapse: When the pelvic organs (such as the uterus, vagina, or bladder) descend from their normal position, a pessary can be used to support and maintain their proper position, alleviating symptoms like pelvic pressure, discomfort, and urinary incontinence.
• Stress urinary incontinence: Pessaries can help support the bladder and urethra, reducing leakage of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, or exercising.
• Postpartum support: Pessaries may be recommended for temporary use after childbirth to support the pelvic organs and promote healing.
• Palliative care: In patients who are not candidates for surgery or those who prefer a non-invasive approach, pessaries can provide relief from symptoms associated with pelvic organ prolapse or incontinence.

Preparation for the Procedure

Before undergoing the selection and application of the urogynecological pessary, there are a few preparatory steps to consider:

• Bladder emptying: It is recommended to empty your bladder before the procedure to ensure accurate measurements and proper pessary fitting.
• Avoiding certain medications: Inform your healthcare provider about any medications you are taking, as some may affect the vaginal environment or cause vaginal bleeding, which can interfere with the procedure.
• Scheduling: The procedure is typically scheduled when you are not menstruating, as menstrual bleeding can make the fitting process more difficult.
• Personal hygiene: Practice good personal hygiene before the appointment to ensure a clean and comfortable environment for the procedure.

The Procedure

The selection and application of the urogynecological pessary involve the following steps:

1. Examination: Your healthcare provider will perform a pelvic examination to assess the vaginal anatomy, measure the dimensions, and determine the appropriate size and type of pessary.
2. Pessary selection: Based on the examination findings, your provider will select the most suitable pessary for your individual needs.
3. Pessary insertion: The pessary will be carefully inserted into the vagina, ensuring proper placement and fit.
4. Instructions: Your provider will provide you with instructions on how to care for the pessary, including cleaning and monitoring for any discomfort or complications.

Evaluation and Fitting

Proper evaluation and fitting of the pessary are crucial for its successful use. The process typically involves a pelvic examination to assess the type and severity of prolapse, as well as the vaginal anatomy and mobility. The healthcare provider will then select an appropriate pessary type and size, considering factors such as patient comfort, degree of prolapse, and potential side effects.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571964/
https://www.healthline.com/health/pessary
https://my.clevelandclinic.org/health/treatments/16036-pessaries
https://www.uptodate.com/contents/vaginal-pessaries-indications-devices-and-approach-to-selection
https://ltlmedical.com/choosing-the-perfect-pessary-a-guide-to-finding-the-right-fit-for-your-needs/
https://www.uptodate.com/contents/vaginal-pessaries-insertion-and-fitting-management-and-complications/print
https://www.brighamandwomens.org/obgyn/urogynecology/forms-and-education-materials/pessary-instructions
https://www.brighamandwomens.org/assets/bwh/obgyn/pdfs/pessary-patient-instruction-2015.pdf

IMPORTANT!

It is crucial to remember that the information provided in this section is not intended for self-diagnosis or self-treatment. If you experience any pain or worsening of a condition, it is essential to seek medical attention for proper diagnostic tests. Only a qualified healthcare professional can provide an accurate diagnosis and recommend appropriate treatment. To ensure the most accurate and consistent evaluation of test results, it is recommended to have them performed at the same laboratory. Different laboratories may use varying methods and units of measurement for similar tests.