What is a pessary? And what are the alternatives?

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Learn about what a pessary is and how it can help incontinence and pelvic organ prolapse. While Uresta is considered a pessary, we explain how it is different from more traditional, prescription pessaries. And why you are much more likely to continue to use your Uresta pessary vs. one fitted by a physician.

What is a pessary?

Pessaries are soft, removable devices inserted into the vagina that can treat urinary incontinence and pelvic organ prolapse. The primary function of a pessary is to support or correct the position of the pelvic organs after they are weakened by pregnancy, age, or other conditions. The best analogy for a pessary is that it is like a sports bra or ankle brace, but for your pelvic organs (uterus, bladder, urethra, rectum, etc.).

Pessaries are reusable for a long period of time and because they are made of non-absorbent material, they do not carry the same toxic shock syndrome (TSS) risk as tampons. Pessaries are safe for long-term use and will not worsen your incontinence or make your pelvic floor muscles weaker.


How does a pessary prevent bladder leakage (stress urinary incontinence)?

By inserting Pessaries vaginally, they sit underneath the urethra and provide a supportive shelf (see diagram above). When you go to sneeze, jump, cough, or laugh, you put sudden pressure on your bladder. When a pessary is inserted, it supports your urethra and bladder under those moments of extra pressure to stop leaks from happening.

Do I need to remove a pessary to pee?

Pessaries insert into the vagina, not the urethra, where pee comes from. Therefore, pessaries aren’t acting as a plug or preventing you from urinating normally (i.e. you don’t need to remove your pessary to pee). They just provide extra support during those moments of pressure to stop urine from leaking out.

 

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Can’t I just do kegels or pelvic floor physiotherapy?

Pessaries can be a great compliment to pelvic floor strengthening (i.e. kegel exercises), and many pelvic floor physiotherapists actually recommend pessaries in conjunction with physiotherapy. Pessaries can provide immediate relief of leaks, as it can take time and effort to see results from physiotherapy.

In some cases, pelvic floor strengthening may not be enough to completely eliminate your bladder leakage caused by stress incontinence. Sometimes you just need a little extra support! And pessaries can be just that!

Will using a pessary make my incontinence worse?

Using a pessary like Uresta won’t make your incontinence worse or your pelvic floor weaker. This means pessaries can be both a great temporary or long-term solution for stress incontinence. Pessaries can be used to provide immediate relief while you strengthen your pelvic floor or wait to see a medical professional. In Canada, Uresta is often recommended by urogynecologists as a temporary solution for women who are on the waitlist for surgery. And for some, Uresta provides enough relief that they remove their names from the surgery waitlist.

Can I just use a tampon?

Some women do experience a reduction in their bladder leaks when they have a tampon inserted. This is because the shape of a tampon applies subtle pressure to the urethra through the vaginal wall. That being said, for most women the pressure applied is not significant enough to reduce or stop their leaks meaningfully.

Pessaries on the other hand are specially designed to provide direct support to the urethra to stop bladder leaks. Uresta also comes in 5 different sizes to find your perfect level of support. Note that using a tampon outside your menstrual cycle can be painful on extraction and drying to the tissues. Plus, extensive use of tampons carries a risk of toxic shock syndrome (TSS).

Downfalls of existing pessaries

While existing pessaries are a less invasive treatment for urinary incontinence than surgery and can provide immediate relief of bladder leaks, they do have their downfalls.

  • Requires a prescription: Traditional pessaries require a physician’s prescription as they need to be inserted and fitted by a medical professional, as it may be ineffective if fitted incorrectly.
  • Long waitlists: Since pessaries require a prescription, you need to make a doctor’s appointment. Physician waitlists, especially after the pandemic, can be very long. Uncomfortable fitting process: Getting a pessary fitted by a physician isn’t always the most comfortable experience and takes a few tries to find the right pessary for you.
  • Finding the right fit: Many women find that they need to try several different types of pessaries before finding the right one. Which likely requires additional physician visits. And as our bodies change (hormone changes, pregnancy, age, weight, etc.), pessaries that were once effective are no longer effective and you need to be fitted for another.
  • The difficulty of inserting & removing: Many pessaries have lacked innovation for years and many women have a hard time managing their pessaries on their own. As a result, many women do not continue to use their pessary. In a clinical study, done by the Society of Obstetricians and Gynaecologists of Canada, only 55% of women continue to use their pessary after 6 months and only 16% continue to use after 1 year.

Why is Uresta better?

Uresta is pessary for stress urinary incontinence (SUI) but offers many benefits over prescription pessaries for SUI.

  • Self-managed: Uresta is the only available over-the-counter pessary in Canada. This means you don’t have to go to a doctor to get fitted or for upkeep – we offer 5 different sizes to find the perfect fit for you. You can try Uresta in the comfort of your home without the pressure of a physician fitting.
  • No long waitlists and no prescription: Uresta ships in 3-5 business days, so you can avoid the long wait lists for physician appointments. Even though we are covered by many insurance programs, you don’t need a prescription! Easy insertion and removal: Uresta comes with a handle that makes it easy to take in and out. Plus, Uresta sits much lower down than a traditional pessary making it easier to insert and remove.
  • Flexibility: Many women complain that the pessaries they are prescribed do not work for all activities, as they experience heavier leeks when exercising or other intense activity. With Uresta, women can switch between sizes depending on their day – many women choose to go a size up for exercise – your life isn’t one size fits all, and your pessary shouldn’t either!

For these reasons, many women find Uresta very easy to use and end up using it long-term. In a clinical study done on Uresta, 90% of the women in the study continued to use their Uresta after 12 months (compared to only 16% for prescription pessaries).

 

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