Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.View Frank Gaillard's current disclosures
At the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to not be relevant to the changes that were made.View Craig Hacking's current disclosures
A vaginal pessary is a device inserted into the vagina which can either be mechanical or pharmaceutical.
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Strictly speaking, a pessary only refers to a medical device designed to be placed in the vagina to support the pelvic floor. Therefore, stating vaginal pessary is tautologous, although this form of words can still be seen in reports, especially when there is the possibility of confusion about the device's location.
Mechanism of action
Mechanical pessaries are inserted to support the vagina, and therefore the other pelvic organs lying superior and posterior to it, preventing prolapse of pelvic organs into the vagina and through the pelvic floor; pessaries secondarily decrease pressure on the bowel and urinary bladder 1.
A mechanical pessary is most commonly used to treat uterine prolapse. It is also used to treat stress urinary incontinence, a retroverted uterus, cystocele and rectocele. A bewildering array of shapes and sizes are available, nevertheless there are two main types:
- support pessaries
- space filling pessaries
A pharmaceutical pessary is imbued with compounds that are active locally.
Pessaries are not a contraindication to performing an MRI (see MRI safety).
An understanding of the radiological appearance of these devices is useful to avoid misinterpreting them, and to be aware when they are malpositioned/mal-located.
- 1. Bugge C, Adams E, Gopinath D, Reid F. Pessaries (Mechanical Devices) for Pelvic Organ Prolapse in Women. Cochrane Database Syst Rev. 2013;(2):CD004010. doi:10.1002/14651858.CD004010.pub3 - Pubmed
- 2. Oliver R, Thakar R, Sultan A. The History and Usage of the Vaginal Pessary: A Review. Eur J Obstet Gynecol Reprod Biol. 2011;156(2):125-30. doi:10.1016/j.ejogrb.2010.12.039 - Pubmed