Ryan Stewart, DO
Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026

Is a pessary right for me?

A pessary is a removable silicone device placed in the vagina to support prolapsed organs. For many women, it’s all the treatment they need. About 92% of women can be fitted successfully, and it works the same day it’s placed.

Who benefits most from a pessary?

Pessaries are a good option for women who:

• Want to avoid surgery, either for now or permanently
• Have health conditions that make surgery higher risk
• Are still planning to have children, since pregnancy after prolapse surgery can weaken the repair
• Want relief right away
• Have prolapse of any stage, including advanced prolapse

I offer a pessary to almost every prolapse patient. There’s no real downside to trying one. If it works, you’ve avoided surgery entirely. If it doesn’t, surgery is still available.

What to expect at a fitting

Here’s what happens:

1. I choose a pessary type and size based on your anatomy.
2. The pessary is placed, and you walk around, sit, and bear down to test it.
3. If it’s comfortable and stays in place, you go home with it.
4. A follow-up visit in 2 to 4 weeks checks the fit.

Finding the right fit sometimes takes 2 or 3 tries with different sizes or types. That’s normal. About 15% of women switch to a different pessary type in the first year.

Types of pessaries

The most common types are:

• Ring pessary: the most popular choice. It allows intercourse and is easy to manage on your own.
• Ring with support: adds a membrane across the center for more support.
• Gellhorn: provides stronger support. It needs to be removed for intercourse.
• Cube: uses gentle suction. It usually requires regular office follow-up in our practice.

Ring and Gellhorn pessaries relieve symptoms equally well in research studies. I usually start with a ring because most women find it the easiest to live with.

What the research shows

In a large multicenter registry, about two-thirds of women were still using their pessary at one year. Among those who continued past the first year, satisfaction stayed high, with 93 to 94% reporting they felt much better at 2 and 3 years.

Women who decide the pessary isn’t for them usually figure that out within the first few months. About 25% of those who stop choose surgery instead.

One thing to know: about 1 in 5 women notice new bladder leaking after a pessary is placed. This happens because the pessary can unmask stress incontinence that the prolapse was hiding. If that happens, we have ways to address it.

Living with a pessary

Most women adjust quickly:

• You should not be able to feel the pessary once it’s in place.
• Cleaning can be done at home or at office visits every 3 to 6 months. Both approaches work.
• Vaginal estrogen cream is often used alongside a pessary to keep the vaginal tissue healthy, though its role in preventing irritation is still being studied.
• You can exercise, travel, and go about your normal life with a pessary in.
• Pelvic floor physical therapy works well alongside a pessary and can improve your results. We have in-office pelvic floor PTs who can work with you.

About 30% of women who use a pessary for 3 years will have at least one episode of vaginal irritation or a small ulcer. These are usually minor and heal on their own once the pessary is removed for a few weeks.

When a pessary may not be the best fit

A pessary may be harder to use if you:

• Cannot come back for follow-up visits
• Have a very short vagina or significant vaginal narrowing
• Have vaginal mesh erosion, a nonhealing ulcer, or undiagnosed vaginal bleeding
• Would rather have a one-time fix

Even in these situations, it’s worth a conversation. The decision is always yours.

References

1. Hooper GL, Moynihan L, Leegant A, et al. Vaginal pessary use and management for pelvic organ prolapse: AUGS-SUNA clinical consensus statement. Urogynecology. 2023. doi:10.1097/SPV.0000000000001293
2. Andy UU, Meyn L, Brown HW, et al. Outcomes at 12, 24, and 36 months in women treated for pelvic organ prolapse with pessary or surgery. Urogynecology. 2025. doi:10.1097/SPV.0000000000001669
3. Yurteri-Kaplan LA, Meyn L, Moalli PA, et al. Outcomes of pessary use at 1 year in women treated for pelvic organ prolapse in a large multicenter registry. Urogynecology. 2022. doi:10.1097/SPV.0000000000001279
4. Cundiff GW, Amundsen CL, Bent AE, et al. The PESSRI study: symptom relief outcomes of a randomized crossover trial of the ring and Gellhorn pessaries. Am J Obstet Gynecol. 2007. doi:10.1016/j.ajog.2007.02.018
5. Carberry CL, Tulikangas PK, Ridgeway BM, et al. AUGS best practice statement: evaluation and counseling of patients with pelvic organ prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641
6. ACOG Practice Bulletin No. 214: Pelvic organ prolapse. Obstet Gynecol. 2019.

← Learn more about Pelvic Organ Prolapse

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Frequently Asked Questions

Is a pessary uncomfortable?

When fitted well, most women cannot feel the pessary at all. Finding the right size and type may take a few visits. Once fitted correctly, it should be comfortable enough that you forget it's there.

Can I have sex with a pessary in?

It depends on the type. Ring pessaries generally allow intercourse. Other types like the Gellhorn need to be removed first. We can talk about which options work best for your lifestyle.

How often does a pessary need to be cleaned?

This varies. Some women learn to remove and clean their pessary weekly at home. Others prefer to have it managed in the office every 3 to 6 months. Both approaches work well.

Can a pessary cause bladder leaking?

About 1 in 5 women notice new bladder leaking after a pessary is placed. This happens because the pessary changes how the urethra sits. If it bothers you, we can adjust the pessary or talk about other options.