Pessary

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A pessary is a small plastic or silicone medical device or form of pharmaceutical preparation which is inserted into the vagina or rectum and held in place by the pelvic floor musculature.

Contents

[edit] Therapeutic pessaries

[edit] Uses

A therapeutic pessary is used to support the uterus, vagina, bladder or rectum. A pessary is most commonly used to treat prolapse of the uterus. It is also used to treat stress urinary incontinence, a retroverted uterus, cystocele and rectocele. It is similar to the outer ring of a diaphragm. It can be placed temporarily or permanently and must be fit by a physician. Most pessaries can be worn during intercourse.

[edit] Care

A physician will provide instruction for the proper care of a pessary. Some patients are instructed to take out, clean with soap and water, and reinsert the pessary every few days or weeks. Others will need to visit the doctor for cleaning.

[edit] Side effects and complications

A pessary can cause increased vaginal discharge, vaginal irritation, ulceration, bleeding, and dyspareunia (painful intercourse for the male or female). Cervical cancer is more likely in older women with a prolonged history of pessary use.

[edit] Pharmaceutical pessaries

[edit] Uses

A pharmaceutical pessary is used as a very effective means of delivery of pharmaceutical substances easily absorbed through the skin of the vagina or rectum, or intended to have action in the locality, for example against inflammation or infection, or on the uterus. An alternative term is suppository, which tends to be used when the primary use is rectal.

[edit] Description

The active ingredient(s) will usually be mixed with a suitable oil (such as cocoa butter) which is solid at room temperature to assist insertion, but melts at body temperature, to enable dispersion.

[edit] Complications

It can happen that the oil will leak, with the potential to spoil clothing. The oil is likely to cause rapid deterioration of any latex rubber contraceptives or sex toys inserted during its presence (plastic or silicone are less likely to be affected). Some people are reluctant to insert anything into the vagina or rectum, so pessaries are more commonly used in some cultures than others.

[edit] Occlusive pessaries

An occlusive pessary is generally used in combination with spermicide as a contraceptive; please refer to cervical cap for more details.

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