Vaginal Support Devices - Managing Urinary Incontinence: Bladder Conditions

Content provided by the Faculty of the Harvard Medical School

Vaginal support devices

For centuries, women have used a device called a pessary, which you can place inside the vagina in a manner similar to a contraceptive diaphragm. A pessary is designed to hold a prolapsed bladder or uterus in place; in the process, it can help prevent urine leakage. Although it sounds old-fashioned and doesn't actually repair the problem, a pessary can mimic the benefit of a surgical bladder neck suspension and is a very practical solution for some women with prolapse that results in stress incontinence.

Pessaries are usually ring- or dish-shaped and are available only by prescription. The pessary must be fitted by your physician in order to support the bladder neck properly when it is inserted. Your clinician may suggest a pessary to use while awaiting surgery. This device might also be an option if surgery is considered medically unsafe or unlikely to relieve your symptoms, if you develop stress incontinence while pregnant, or if you prefer a nonsurgical option. But it's usually not helpful if you have urge incontinence. If you have a vaginal infection, it will have to be treated before you use a pessary.

If your pessary fits properly (and it typically takes two or more tries to select the ideal size and style), it should not fall out during normal activities and should not interfere with regular urination or having a bowel movement. Some pessaries can be left in place during intercourse, although you may be more comfortable removing it. A health professional can work with you until you are comfortable inserting the device and removing it for cleaning. Some pessaries must be removed every few days; others can be left in place for several months and are removed for cleaning at regular medical visits.

The National Institute of Child Health and Human Development is currently comparing how use of a pessary compares with pelvic exercises in controlling stress incontinence (whether associated with prolapse or not) in women. For some women with exercise-related stress incontinence, simply inserting a tampon before engaging in activity provides enough extra support to prevent leakage.

Last updated:	September 05, 2008