Genitourinary Prolapse and Ring Pessary Insertion
Genitourinary (GU) prolapse occurs when the normal support structures for the organs inside a women's pelvis are weakened. The result is that one or more of the organs (the uterus, the bladder or the rectum) can drop down (prolapse) into the vagina. This may cause no symptoms at all but may also lead to discomfort in the vagina, including a dragging sensation or feeling of a lump in the vagina, which can be quite distressing. It may also cause bladder or bowel symptoms.
The aim of treatment of a prolapse is to ensure you are:
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Are comfortable and pain-free.
Are able to pass urine and stools adequately and have no problems with urinary or faecal incontinence.
Are able to have sex comfortably.
Do not experience any complications relating to the prolapse, such as urine infections or ulceration of the prolapse.
There are different treatment options available which will be discussed with you, but this leaflet will only go into detail about vaginal ring pessaries.
A vaginal pessary: A vaginal pessary can be a very good way to manage GU prolapse.
It may be used by women who:
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do not wish to have surgery,
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by women who are still of child-bearing age,
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by women who are waiting for surgery,
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by women who have other illnesses that may make surgery more risky.
The pessaries are usually in the shape of a ring and are usually made of silicone or plastic.
The ring is inserted into your vagina. It is left in place and helps to lift up the walls of your vagina and any prolapse of your womb. It needs to be changed every 6 months.
You will be given an appointment with a GP for the initial assessment and discussion of ring fit.
You will then be booked for an appointment to fit the ring, this may be a 10 or 20 minute appointment. You will then need the ring changing every 6 months; this may be done with the GP or sometimes with the practice nurse. Please check this with your GP.
During the first appointment you will undergo internal examination and assessment for ring

pessary fit. You may find it a little uncomfortable during the ring fit but when it is in place you should have no discomfort from the ring.
Occasionally the ring may fall out, most commonly if straining to open your bowels. You do not need to worry if this happens, it may mean you need a different size fitted. Just contact the surgery to arrange reassessment with the doctor who fitted it for you.
If you have pain or difficulty passing urine after you have a vaginal pessary inserted, you should speak to your GP as soon as possible. You may need the pessary changing for a different size.
You will need to book every 6 months to have the ring pessary changed . Please book this appointment at reception. You should also request a prescription for the ring prior to your appointment and bring it with you to the appointment. This will be on your repeat prescription.
Vaginal pessaries do not usually cause any problems but, very rarely, they may affect the skin inside your vagina which can become dry and sore. You may be advised to use an oestrogen cream for 4-6 weeks prior to having a pessary change. This will help to treat any dryness of the vaginal skin and reduce any pain when having the ring changed. This will be discussed with you by your GP.
If you have any questions having read this leaflet please contact your doctor through the surgery.