A pessary is a removable device that is inserted into the vagina to provide support in the area of a prolapse. It is a firm ring that presses against the wall of the vagina and urethra to help decrease pressure or rubbing. Pessaries come in many shapes and sizes, and the type of pessary that is appropriate for each patient depends on the condition being treated. Some types of pessaries include:

• Ring pessary: This circle-shaped device is often the first type of pessary doctors recommend. You can easily insert and remove it without a doctor’s help.
• Gehrung pessary: A U-shaped pessary that’s used for more advanced uterine prolapse, it is molded to fit its user.
• Gellhorn pessary: This disk-shaped device with a small knob in the middle is used for more severe prolapse.
• Donut pessary: This is a ring-shaped pessary with a hollow center.
• Cube pessary: This pessary is used for advanced-stage prolapse. It’s compacted down and inserted into the vagina where it uses suction to support the areas affected by prolapse.

The pessary is an effective tool in the management of a number of gynecologic problems. It is most commonly used in the nonsurgical management of pelvic support defects, including genuine stress urinary incontinence, vaginal vault prolapse, cystocele, enterocele, rectocele, and uterine prolapse. A properly fitted pessary can simulate the result of surgical correction of incontinence, thereby yielding diagnostic and prognostic information. Women who can insert and remove the pessary on their own can remove it for cleaning weekly or even nightly. Follow-up visits should take place every six to 12 months to ensure the pessary is fitting properly and not causing any discomfort.