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Understanding pelvic organ prolapse and why a pessary can help

Nadia Qureshi

Nadia Qureshi



Thursday, May. 21, 2020

Muscles and tissues supporting the pelvic organs (the uterus, bladder or rectum) can become weak or loose over time, allowing one or more of the pelvic organs to drop or press into (or even out of) the vagina. If you have sensations of heaviness or pressure when you stand for too long, if you have bouts of incontinence or if you feel a bulge coming out of your vagina, it may be a sign of a prolapse of a pelvic organ.

Many women think that their symptoms are “normal” and are embarrassed to talk to a healthcare professional about them, but they shouldn’t be. Pelvic organ prolapse is treatable. Here’s what you need to know.

Performing an assessment

After carefully reviewing your medical history, a healthcare professional will perform a pelvic exam to identify pelvic organ prolapse and assign a “grade” to classify the severity of your condition. This grade will also be useful to monitor your progression and your response to treatment.

“Grade 1” is when an organ drops slightly, but you don’t notice anything in the vagina.

“Grade 2” is when there is some bulging in the vagina, with the budge coming out slightly. For “Grade 3,” the bulge is coming quite a bit outside of the vagina and needs to be pushed back in with your hands.

For “Grade 4,” it feels like something is falling out of you!

Treatment options, including pessaries

If pelvic organ prolapse is causing you issues, know that you are not alone and that different treatment options are available to you, including pelvic therapy, surgery and pessaries.

What is a pessary, you ask? Simply put, it’s a brace for your pelvis. Pessaries come in different shapes and sizes and are most commonly prescribed for people who are considered “Grade 3” or “Grade 4”, but can also help people who are considered “Grade 2” function as well.

The pessary fits inside the vagina to help support the weakened connective tissue when the muscles have done all they can.

A pessary is considered a medical device and can be put in place by a family doctor (if they are comfortable), a gynecologist or a qualified pelvic therapist. A qualified pelvic therapist can also answer any questions you have or practice using the pessary with you, and will communicate with your family doctor or any other healthcare professional who’s supporting you to maximize collaboration and ensure you receive the best possible care.

Even if you decide to wear a pessary, you will be assigned specific pelvic floor exercises to perform, which you should practice to decrease abdominal pressure on your pelvis.

For further guidance, contact a Lifemark clinic near you or visit our Pelvic Health page on Lifemark.ca.

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