Vaginal pessary for prolapse

Transcription

1 Vaginal pessary for prolapse Information for patients This leaflet sheet answers some of the questions you may have about having a vaginal pessary fitted. It explains the benefits, the risks and the alternatives as well as what you can expect when you come to hospital. If you have any questions or concerns, please do not hesitate to speak to the doctors or nurses caring for you. What is a vaginal pessary? It is a removable device that fits into your vagina to help support a pelvic organ prolapse. It does this by adding support to the walls of your vagina. It may ease the symptoms of prolapse but it will not cure the condition. You have the pessary put in at an outpatient clinic you do not need surgery. Depending on which type you are given, you may need to take it out every day or wear it inside you for several months at a time. Why do I need a pessary? Your uterus, bladder or rectum has dropped down into your vagina because your pelvic floor muscles are weak and/or damaged and not providing enough support. This is called a pelvic organ prolapse. Prolapse can be caused by things such as: childbirth and pregnancy

2 ageing and the menopause your lifestyle including frequent constipation, smoking and being overweight exercise such as lots of heavy lifting previous pelvic surgery genetic predisposition. What are the benefits? It may ease your symptoms and make you feel more comfortable, or they may go away completely. You do not need surgery the pessary is fitted by a doctor or specialist nurse. It can be used to make you more comfortable while you are waiting for surgery. What are the risks? There are a few side effects and risks: You may notice more vaginal discharge than normal and this may smell. Your may have vaginal irritation. If you have passed the menopause you may find it helpful to use oestrogen cream or a vaginal tablet. Long-term use may cause ulceration or other problems such as infection. You can avoid this by using vaginal oestrogen and by ensuring that the pessary is regularly checked. Are there any alternatives? Your symptoms can also be treated by doing pelvic floor muscle training or having surgery. Your doctor will discuss these with you. How is the pessary fitted? You will have your vaginal pessary fitted by a doctor or a specialist nurse at the urogynaecology outpatient clinic. They will talk to you about your symptoms to decide which type is best for you. They work out the size and type of your pessary by trial and error. It may take a few tries to get the right one. You will have a vaginal examination to decide the size of the pessary you need. The pessary is then put into your vagina and moved into place to sit

3 behind your pubic bone. It takes about 30 seconds to put it in and get it in the right place. After the first fitting you will be asked to walk around for minutes and to empty your bladder if possible. This will help them to judge whether you have the right sized pessary. A properly fitted pessary should not cause you any pain or discomfort. Another size may be fitted if: you feel any discomfort the pessary falls out you cannot pass urine. Once you feel comfortable with your pessary, you will be able to go home. You should be able do your usual daily activities without any problems. We will ask you to come back for a follow-up appointment in four six months time. What kind of pessary will be given? The doctor or nurse specialist will decide which kind of pessary is most suitable for you. There are a number of different types, including ring, gellhorn and cube. They also come in various sizes. How often do I need to change my pessary? If you have a ring or gellhorn pessary fitted, your pessary is changed every four six months. You will come back to see the doctor or specialist nurse who will change your pessary and check your vagina for ulceration or other problems such as infection. We can teach you how to change your pessary yourself if you prefer. You can do this safely at home. If you have a ring pessary, your GP may be able do routine changes. If you have a cube pessary, you need to take it out and clean it every day with soap and water. The nurse specialist will teach you how to do this at your clinic appointment. It is important that you come to all your appointments. If you leave the pessary in for too long, it can be hard to take out. Sometimes you may need to have it taken out under general anaesthetic. Can I wear the pessary during sexual intercourse?

4 Please talk to your doctor or nurse about this. You can have sex with certain types such as a ring pessary. But you cannot with others such as a gellhorn pessary. If you have a cube pessary, you need to take it out before intercourse. Who do I contact with queries and concerns? If you have any problems with your pessary, or have any queries or concerns about it, please contact the urogynaecology department. You details will be given to one of the specialist nurse who will call you back. Tel: , 9am 5pm, Monday to Friday Sharing your information We have teamed up with Guy's and St Thomas' Hospitals in a partnership known as King s Health Partners Academic Health Sciences Centre. We are working together to give our patients the best possible care, so you might find we invite you for appointments at Guy's or St Thomas'. To make sure everyone you meet always has the most up-to-date information about your health, we may share information about you between the hospitals. Care provided by students King s is a teaching hospital where our students get practical experience by treating patients. Please tell your doctor or nurse if you do not want students to be involved in your care. Your treatment will not be affected by your decision. PALS The Patient Advice and Liaison Service (PALS) is a service that offers support, information and assistance to patients, relatives and visitors. They can also provide help and advice if you have a concern or complaint that staff have not been able to resolve for you. The PALS office is located on the ground floor of the Hambleden Wing, near the main entrance on Bessemer Road - staff will be happy to direct you. Tel: Textphone: Fax: kch-tr.pals@nhs.net

5 If you would like the information in this leaflet in a different language or format, please contact PALS on Corporate Comms: 0677 PL615.1 October 2013 Review date October 2016