When fitting a pessary the clinician should perform a normal pelvic examination prior to the introduction and fitting of a pessary. The pelvic exam can help to determine the proper pessary size. The pessary fitting set can also be a useful tool in fitting most pessaries.
All of our vaginal pessaries fold or compress to ease insertion and removal. Fitting instructions for each style of pessary are included in the pessary package and should be followed. Patients should be instructed on pessary insertion and removal, as well as cleaning procedures as outlined in the package insert. Patients should be instructed to report any discomfort immediately and regular follow-up visits should be scheduled.
A properly fit pessary should be large enough to perform its designed function but not cause any undue pressure or discomfort. The clinician should be able to insert a finger between the outer rim of a properly fitted pessary and the vaginal wall.
All pessaries are contraindicated in patients who have acute genital tract infections, pelvic infections or are non-compliant. To disinfect pessaries, use any of these procedures:
- Autoclave at 15 lbs. of pressure at 250 degrees Fahrenheit or 121 degrees Celsius for a period of 10 minutes. DONUT PESSARIES CANNOT BE AUTOCLAVED.
- Boil for 15 minutes
- Cold sterilize with Cidex (Johnson & Johnson) or Chlorephenyl (Bard-Parker), then thoroughly rinse with water.