The pessary is a medical device that is inserted and held in the vagina; supports the vaginal walls and helps keep the pelvic organs that have moved in the correct position. You can usually insert and remove it yourself, but you must go to your gynecologist regularly to inspect and perform proper maintenance.
Steps
Part 1 of 3: Insert the Pessary
Step 1. Wash your hands
Use warm soapy water and, at the end, dry them with paper towels.
Step 2. Remove the wrapper
Remove the pessary from the foil or plastic package; if it is not sold in a sterile package, you should wash it with soap and water before carefully drying it.
Remember that this device is available in different sizes; the gynecologist should recommend the right one according to your needs
Step 3. Fold it in half
Grab it on the side of the knob and use your fingers to fold the ring into two parts.
Examine it carefully. If you are using an open loop model, you should notice notches along the inside edge; if you have chosen a ring but with support, you should see openings in the center of the structure. In both cases, these areas are the flexible points that allow you to bend the pessary and that you should grab; the device should only bend in these areas
Step 4. Apply water-based lubricant
Use your fingers to spread a small amount on the end of the ring without the knob.
- Note that the curved portion should be facing up as you hold the device.
- The lubricant should cover the entire bent end that is on the opposite side of the knob; this is the edge that should be inserted first.
Step 5. Spread your legs
You can remain standing, lying or sitting; since the pessary can be inserted in all these positions, choose the one that is most comfortable for you.
- If you decide to sit or lie down, bend your knees and spread them as far as possible without feeling discomfort.
- If you prefer to stand and are right-handed, place your left foot on a chair, stool or toilet lid while keeping your right foot on the ground; lean towards the left leg as you insert the pessary.
- If you are standing and left handed, place your right foot on a chair, stool or toilet lid while keeping your left foot on the ground. lean towards your right leg as you insert it.
Step 6. Spread your lips
Use the fingers of the non-dominant hand to open the labia of the vulva.
You should still have the folded device in your dominant hand; use the latter to proceed with the insertion
Step 7. Gently slide it into your vagina
Keep it bent and push the lubricated end through the vaginal opening until it reaches the deepest possible position without pain.
Note: You must enter it lengthwise
Step 8. Release it
Let go of the grip; in this way the ring unfolds and recovers its normal shape.
If you feel discomfort, use your index finger to rotate the device; the end with the knob should be facing up and you should not feel the pessary once it is correctly positioned
Step 9. Wash your hands again
Remove your fingers from the vagina and wash them immediately with warm soapy water before drying them with kitchen paper.
This phase completes the insertion process
Part 2 of 3: Caring for the Pessary
Step 1. Check the sensation
A pessary of the right size and design shouldn't be uncomfortable; you shouldn't feel it at all.
- You should also do some tests by pushing with the abdominal muscles as if you were going to defecate; the device should not move or slip when you use the bathroom.
- If changing the position of the ring does not solve comfort or other problems, the pessary may not be the right size or shape; in that case, you need to consult your gynecologist.
Step 2. Clean it regularly
You should take it out at least once a week and clean it before putting it back in its place.
- Ideally, you should take it off and clean it once a day. Some women remove it in the evening, wash it, and put it back on the next morning, but you should ask your gynecologist if this routine is suitable for your health condition.
- When you wash it, use mild soap and warm water; rinse it and dry it thoroughly using absorbent paper before inserting it again.
- If you find it difficult to put on and remove the device, you should go to the doctor about every 3 months for a professional check-up and cleaning; do not leave it in the vagina for more than 3 consecutive months without washing it.
Step 3. Clean it, in case it comes out spontaneously
Although it is possible to pee without any difficulty, the pessary may slip out during defecation; if so, you need to wash it carefully before inserting it again.
- Inspect the toilet every time you use it to see if you have "lost" the device.
- If so, rub it with warm water and mild soap, soak it in denatured alcohol for 20 minutes, then in water for another 20 minutes; wash it once more with soap and water, rinse it, dry it and insert it into your vagina.
Step 4. Schedule frequent visits with your gynecologist
Even if you are perfectly capable of putting on, taking off and cleaning the pessary on your own, you should still have a medical check-up every 3-6 months.
- The first appointment should be after about two weeks and the second within three months.
- Go to the gynecologist every 3 months until 12 months have passed; thereafter, you can only schedule a couple of appointments per year.
Part 3 of 3: Remove the Pessary
Step 1. Wash your hands
Before removing the device you must wash them with warm water and neutral soap; when finished, dry them with absorbent paper sheets.
Step 2. Spread your legs
You can remain standing, sitting or lying down; you can use the same position you have chosen for the insertion phase.
Remember to keep your legs apart and your knees bent; if you are standing, place your non-dominant foot on a stool and lean over the other leg during the procedure
Step 3. Insert a finger
Use your index finger to find the device in your vagina and hook it with your fingertip, sliding it over or under the rim.
- To be more precise, you should find the knob, notch or opening along the edge and grasp the pessary at this point.
- Remember that it should be just below the pubic bone.
Step 4. Tilt it and remove it
Use your finger to tilt it slightly and then pull it down until it slips out of the vagina.
- Try not to tilt it more than 30 °.
- It may be useful to fold it as you remove it, but it does not need to be folded as much as it is in the insertion phase; the vaginal walls should dilate well enough to allow extraction without any other intervention.
- If you have difficulty, push down as if you were going to defecate; this movement should push the ring forward, making it easier to grab and extract.
Step 5. Wash your hands again
After removing the pessary you should wash them with very hot soapy water; do not neglect to dry them carefully.
- Clean or discard the device, as needed, after removing it.
- This phase concludes the extraction process.
Warnings
- If using the pessary causes vaginal bleeding, foul-smelling discharge, pain or pressure in the pelvic area, difficulty urinating or defecating, intimate irritation / itching, discomfort in the lower abdomen (swelling, pain, cramps or pain) or fever, consult the your gynecologist.
- Opt for tampons instead of tampons to avoid discomfort and possible interference with the device.
- Some models can damage condoms and diaphragm making them ineffective birth control; in case of doubt, also evaluate this aspect with the gynecologist.
