So you just got your pessary- congrats! Your physiotherapist explained how to insert and remove it and you practiced a few times with her in the clinic, but you can’t quite remember everything she said. Here are insertion and removal guidelines for one of the most common styles of pessaries for stress urinary incontinence, with or without prolapse – the incontinence ring with or without support.
Insertion
- Wash your hands
- Position: half squat or one foot on a stool or lying on your back, propped up with pillows
- Apply lubricant (preferably organic, paraben and glycerin-free, water-based (not silicone)) to vaginal opening and entering end of the ring pessary
- Fold ring pessary in half (as an “A” or a “V”) with knob to the side
- Spread the lips of your vagina apart with one hand and insert the pessary at the base of the vagina with the other hand
- Gently push the pessary as far back into the vagina as it will go
- Ensure proper positioning once inserted: bring the knob to the front (behind the pubic bone/on the urethra); move it by inserting 1 finger into one of the larger holes in the pessary (only for ring with support) or by pushing the knob directly
Removal
- Wash your hands. Use a glove on one hand if you find that helps to get a better grip
- Push the knob to one side (to your right or left hip)
- Grab the rim of the pessary with your thumb and index finger, tilt it slightly down and gently pull down and out, folding it with your other hand as you remove it. Instead of using your other hand to fold it as you remove it, you can bend it slightly by pushing your thumb down and using your ring finger to push up on the underside of the pessary as you withdraw it.
- Tip: can bear down to lower the pessary or tie dental floss onto the pessary to aid in removal. Try in standing vs lying
- Tip: if you cannot bend/fold it, turn pessary to a 45* vertical angle so you are not withdrawing it horizontally
Check out this video on insertion of a ring with knob pessary. https://www.youtube.com/watch?v=DT2RG6_bONM
Want tips on how to clean and care for your pessary? Check out our blog on “Pessary Removal and Cleaning”. https://torontopessaryclinic.com/pessary-removal-and-cleaning/
Not sure if it is sitting and fitting correctly? Read more on this in our blog “How do I Know if my Pessary is Working? https://torontopessaryclinic.com/how-do-i-know-if-my-pessary-is-working/”.
If you are still unsure how to insert or remove your pessary, book in to see us. We would be thrilled to review this with you until you are 100% confident you can manage independently!
The information in this blog is provided as an information resource only and should not be used as a substitute for seeking personalized direction from your overseeing physician. Please consult your healthcare team before making any decisions about your pessary treatment plan, which is unique to you and your overall health. Toronto Pessary Clinic expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this blog.