Pelvic organ prolapse - Pessary treatment

Abstract

Pessary treatment of prolapse is one of the oldest remedies in medicine and is an important conservative treatment that is particularly valuable for the physically frail. Pessaries can be used for diagnosis and treatment of prolapse, for voiding dysfunction and urinary incontinence and for the management of incontinence or retention during pregnancy. The guidelines for pessaries and the role of the woman in taking care of her pessary is emphasized. The main types of pessary and the specific indications are reviewed - choice will depend on the type of prolapse and the vaginal anatomy. The success rate and the complications and their management are outlined. The role of pelvic floor exercises and supportive garments are reviewed. The importance of future randomized control trials and establishment of clinical guidelines is emphasized. © 2008 Springer-Verlag London.