Supportive devices

Abstract

Pessaries were developed many centuries ago to manage troublesome genital prolapse in an era when surgical management was not an option. In 1867, according to the American Medical Association, there were 123 types of pessaries available [1]. During the last century, the improved safety of surgical intervention for the treatment of prolapse resulted in the decline of pessary use. Pessaries were even viewed as dangerous as they were known to cause the occasional fistula when left unattended. Pessaries are currently experiencing a rebirth in both design and in indications for use. Pessaries and related supportive devices are now viewed as an excellent conservative management alternative for the treatment of urinary incontinence and pelvic floor prolapse, as well as a useful diagnostic tool to determine the appropriate surgical procedure for pelvic floor reconstruction. © 2006 Springer-Verlag London Limited.