Pessary therapy involves placing various shapes deep into the vagina, which provides support for the pelvic suspension apparatus, which holds the reproductive organs in the correct position. There are various shapes and sizes of pessaries on the market, which facilitates individual selection, guarantees better comfort and effectiveness of this form of urinary incontinence therapy.
Pessaroterapiais one of the effective forms of therapy for urogynecological pathologies, which includes the reproductive organ and the urinary system, i.e. all kinds of abnormalities in the statics of the pelvic organs, including include, among others uterus, bladder and intestines. The most common problem is when stress urinary incontinence or a prolapse of the pelvic organs occurs. The latter abnormality is associated with the weakening of the suspension apparatus - muscles, tendons, ligaments. Due to great discomfort, many ailments qualify for surgical treatment, but doctors choose a less invasive form of treatment as the first-line treatment - pessaries.
What is a pessary?
Pessaries are silicone inserts of various sizes and shapes, individually adjusted. The material used in the production of pessaries is antiseptic to eliminate any risk of contamination during use. The diverse offer on the market allows for the best selection of discs, which ensures their high efficiency.
Pessaries: types
- Urethral pessary- dedicated primarily to women with depletion of the reproductive organ, and its action is to support the structures of the reproductive organ. If the tubular pessary is to be helpful for women with urinary incontinence, it should be equipped with a special collar / thickening, referred to in the industry as calotte. It is designed to support the urethra, which effectively prevents uncontrolled transfer of urine drops from the bladder to the urethra. The tubular pessary can be used not only in stress urinary incontinence, when the involuntary release of a drop of urine occurs in the event of excessive physical activity, but also in mixed incontinence. The mechanism of stress urinary incontinence is based on the abdominal pressure incontinence. Increased pressure in the abdomen as a consequenceoverexertion causes the upper part of the urethra to open.
- Ring pessary- made of an aluminum plastic core that can be freely deformed, which allows for a perfect fit. The indication for use is primarily stress urinary incontinence, but a history of postoperative treatment.
- Collar pessary- additionally equipped with a protrusion / thickening in the area of the urethra The use of such a form of a silicone ring is not limited only to lowering the reproductive organs (vaginal walls), but also to the complete reduction of their loss with coexisting urinary incontinence.
How to choose the perfect pessary
In order for the pessary to fulfill its function, it should be well chosen. Therefore, it is extremely important to approach each patient individually in order to understand her needs. A visit to a specialist is required, preferably in the field of urogynecology. To help in choosing the right disc, the doctor performs an ultrasound of the pelvis. Being a small pessary may not fulfill its function and cause the client's dissatisfaction, while a too large one may quickly slide out of the vagina, and may also cause a feeling of discomfort - a foreign body. A disproportionately large disc can be cumbersome to insert and remove, further increasing the level of frustration.
Indications for pessary therapy
The main indications for starting pessary therapy are:
- stress urinary incontinence, i.e. releasing a drop of urine in a situation of increased physical exertion, e.g. during sports, sneezing, laughing
- overactive bladder
- disorders of the voiding process, i.e. urination - residual urine
Advantages of pessary therapy
Undoubtedly, pessary therapy has many advantages. These include :
- low invasiveness in the treatment of urogynecological diseases, which makes the once common surgical treatment a second-line treatment
- easy accessibility and a large selection of pessaries, thanks to which the disc selection is individual and synchronized with the patient's pelvic anatomy
- no side effects recorded (the fact of bacterial infections being a consequence of improper hygiene when using pessaries is ignored)
- putting on pessaries is not problematic, but of course every doctor, when starting pessarotherapy, should explain in detail the mechanism of pessary operation, as well as the method of inserting them
Do you wear a pessary around the clock?
In most cases, there is no need to wear the pessaries around the clock, they are removablefor a night's rest. If urinary incontinence occurs only during increased physical activity, you can limit wearing the insole only during sports. Many women ask about intercourse - well, it is recommended to remove the pessary before each intercourse.
Side effects of pessotherapy
Despite the almost complete absence of side effects of pessary therapy, it should be mentioned that, unfortunately, long-term use of the discs may increase the predisposition to the occurrence of vaginal discharge, therefore it is extremely necessary to take care of intimate hygiene and cleanliness of the disc. Each disturbing symptom should be reported by the patients to the attending physician. Long-term treatment with the use of pessaries without significant improvement is an indication for considering surgical treatment of the problem of statics of the pelvic organs.