Prolapse and Pessary Management: A Complete Guide
Pessary Fitting Service Now Available
If you’ve been told you have pelvic organ prolapse (vaginal prolapse), or if you’ve noticed a sense of heaviness, bulging, or dragging in your vagina, a pelvic floor physiotherapist can help.
Pelvic organ prolapse affects up to 50% of women at some point in their lives. The good news is that prolapse is often manageable with pelvic floor physiotherapy. Treatment often involves pelvic floor muscle strengthening exercises, education and advice such as that relating to healthy bladder and bowel habits, general exercise advice and lifestyle changes such as reducing aggravating activities. In addition, a vaginal pessary might be recommended. For many people, a well-fitting pessary can make a real and immediate difference to prolapse symptoms, improving comfort, confidence, and quality of life.
We’re pleased to share that pessary fitting is now available at our clinic, alongside our existing pelvic health physiotherapy services. Read on to find out more about pessary management for pelvic organ prolapse, or to read more about pelvic health physiotherapy at Inner Strength Bayside, click here.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse happens when the muscles and connective tissue supporting the pelvic organs (the bladder, uterus, and bowel) weaken or stretch, allowing one or more of these organs to descend into the vaginal wall.
Common contributing factors include:
- Pregnancy and vaginal birth
- Menopause and reduced oestrogen levels
- Chronic coughing, constipation or straining
- Heavy lifting over time
- Being overweight or obese
Prolapse Symptoms
Symptoms vary from person to person and don’t always align with the degree of prolapse seen on examination. Prolapse symptoms can include:
- A feeling of heaviness, pressure, or dragging in the vagina
- A visible or palpable bulge at the vaginal opening
- Symptoms that worsen as the day goes on or with standing and activity
- Difficulty emptying the bladder or bowel fully
- Lower back ache
If any of this sounds familiar, it’s worth having an assessment — prolapse is common, treatable, and nothing to feel embarrassed about.
What Is a Pessary?
A pessary is a removeable device, typically made of medical-grade silicone, that is inserted vaginally to support the vaginal walls, correct the prolapse and relieve prolapse symptoms. Pessaries come in a range of shapes and sizes and the right pessary depends on the type and severity of your prolapse, your vaginal anatomy, and your individual lifestyle needs.
Pessaries are a well-established, evidence-based, non-surgical option for managing prolapse. They can be used:
- As a long-term management strategy for those who wish to avoid or delay surgery
- To assist safe return to high impact exercise post-partum
- Simply to stay active and symptom-free during daily activities
What to Expect from Pelvic Floor Physiotherapy for Prolapse
A pessary fitting appointment can be made subsequent to an initial appointment for prolapse. During your first appointment, your physiotherapist will conduct a thorough assessment, provide advice specific to you and prescribe pelvic floor exercises. According to current evidence-based recommendations, pelvic floor exercises should be offered as first line management for prolapse. While a pessary provides mechanical support and symptom relief, it does not replace pelvic floor muscle exercises. A combination of conservative treatments lead to the best results. We are dedicated to providing high quality care. If you are considering whether a pessary might be useful for you, the first step is to book an initial pelvic floor physiotherapy appointment. There will be a discussion about the process and what is involved so that you can make a well-informed decision before proceeding. After consultation, a pessary fitting appointment can be booked in collaboration with your physiotherapist.
If you’d like support, our team is here to help. Call us on (03) 8555 4099
Click here to book an initial pelvic health appointment.
This blog is general information only and is not a substitute for individual clinical advice. Please speak with your clinician about what’s right for your situation.
Written by Grace Edwards, Physiotherapist (Post Grad Cert Pelvic Floor Physiotherapy) at Inner Strength Bayside. Grace has done further training specifically in pessary management for prolapse.
