Silicone Ring Pessary with Knob (without support)

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) 

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

The ring pessary is the most commonly prescribed type and suits most cases of mild to moderate prolapse. It works by sitting behind the pubic bone and supporting the vaginal walls. Sizes are measured by external diameter in millimetres (mm) — our ring pessaries range from 51mm to 108mm to accommodate different anatomies.

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.

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

What is a ring with knob pessary?

Also known as a urethral pessary. Key features:

• Ring design with a central knob that sits behind the pubic bone to support the bladder neck and urethra
• Reduces stress urinary incontinence (SUI) by increasing urethral resistance
• Also supports uterine prolapse
• Requires good pelvic floor muscle tone to retain the pessary in place
• Suitable for self-management once fitted
• Available with or without a supporting membrane

Note: This is the only incontinence pessary suitable for use in pregnancy (after the first trimester), under guidance from an obstetrician or healthcare professional.

What is an iDish pessary?

Urethral dish pessary with enlarged support pilot. Key features:

• Dish-shaped pessary with an enlarged urethral support pilot for greater bladder neck support
• Applies urethral pressure to reduce urine leakage — particularly effective during coughing, sneezing and exercise
• Can also help manage pelvic organ prolapse symptoms alongside SUI
• Provides more targeted urethral pressure than a standard dish pessary
• Intended for clinical fitting and management by a trained healthcare professional
• Available with a supporting membrane for additional internal support
  

What is a dish pessary?

Dish pessary with smaller knob support. Key features:

• Features a smaller knob or raised support compared to the iDish, providing gentle bladder neck and urethral pressure
• Suitable for second- or third-degree uterine prolapse, cystocele and rectocele
• Can help reduce stress urinary incontinence whilst also managing prolapse symptoms
• A versatile option where both prolapse support and mild urethral support are required
• Made from medical-grade silicone for comfort and long-term use
• Available with or without a supporting membrane