Cube Pessary (Without Drain)

A vaginal pessary is a medical device inserted into the vagina to provide internal support to the pelvic organs. It is most commonly used to manage pelvic organ prolapse (POP) — a condition where the bladder, uterus, or bowel descends into or beyond the vaginal wall — and to relieve symptoms of stress urinary incontinence.

Pessaries offer a safe, non-surgical alternative for women who prefer to avoid or delay an operation, are not suitable candidates for surgery, or are waiting for a procedure. They are also widely used during pregnancy and in older patients.

Common reasons a pessary may be recommended include:

• Pelvic organ prolapse of the vaginal walls supporting (bladder prolapse, uterine prolapse, or bowel prolapse)
• Stress urinary incontinence — leaking urine when coughing, sneezing, or exercising
• Pelvic pressure or heaviness
• Support during for pelvic organ prolapse during pregnancy (after 1st Trimester RING and RING with Knob ONLY)
•  or postpartum recovery (from 6weeks postpartum) 
• When fitted correctly, most women find a pessary comfortable and can go about daily life without noticing it is in place.

CONTRAINDICATIONS

A pessary should not be used in the following situations:

• The patient is unable to comply with regular follow-up and is not able to self-manage the pessary
• Active vaginal or pelvic infection, inflammation, or unexplained bleeding
• Ongoing vaginal or cervical cancer
• Severely atrophic vaginal tissue that has not responded to pre-pessary oestrogen treatment
• Vaginal dimensions that make fitting too difficult
• Identifiable synthetic vaginal mesh erosion

CAUTIONS

A pessary may be an option but additional caution is required when:

• Poor vaginal health - vaginal oestrogen therapy may be required prior to fitting
• Previous radiotherapy affecting the vaginal tissues
• Synthetic mesh has been placed in the vagina during previous surgery
• Pre-existing vaginal pain (e.g. pudendal neuralgia)
• The patient is immunosuppressed

Known complications

The following complications are recognised with pessary use. Vaginal changes are common but do not always mean pessary use should stop:

• Very common: increased vaginal discharge
• Common: erosion or abrasion of vaginal skin, vaginal bleeding, discomfort, pessary expulsion, new bladder or bowel symptoms
• Uncommon: vaginal ulceration, difficulty with removal, infection, incarceration
• Rare : fistula Formation

Choosing the right pessary type and size is done by a trained healthcare professional — usually a gynaecologist, urogynaecologist, specialist nurse or specialist pelvic health physiotherapist — through a pelvic examination. There is no single "correct" size; it is highly individual and based on your anatomy.

During the fitting appointment, your clinician will assess:

• The type and grade of prolapse or the nature of your symptoms
• The size of your vaginal vault and the strength of the pelvic floor muscles
• Whether you are sexually active (which may influence device choice)
• Your personal preference for self-management versus clinic management

It is normal to try more than one size before
finding the best fit. A well-fitted pessary should feel comfortable at rest,
during movement, and when passing urine, without falling out or causing
pressure.