What is a pessary? And what are the alternatives?

‘Liberating’, ‘life-saver’, ‘gamechanger’ are just a few of the words women use to describe Uresta (just check out our testimonials). However, we also get tons of questions. How is Uresta different from a typical pessary? How does it work? Why can’t I just do kegels or use a tampon? What are the downfalls of existing pessaries and why is Uresta better?

What is a pessary?

Pessaries are soft, removable devices inserted into the vagina that can support both urinary stress incontinence and pelvic organ prolapse. The primary function of a pessary is to support or correct the position of the uterus or other organs after they are weakened by pregnancy, age, or other conditions. The earliest mention of pessaries was in Egyptian papyrus scrolls, and they have been made out of wood, bone, and metal throughout history. However today, pessaries are most often made of rubber and medical-grade silicone.

How does it work?

Pessaries do not act as a plug against pee leaks and it is not inserted into the urethra, where pee comes from. Pessaries are inserted into the vagina and are designed to support the urethra and bladder wall by applying gentle compression of the urethra against the pubic bone. Support pessaries, the most common type of pessaries used for urinary incontinence, provide a supportive shelf for pelvic organs. Thus, pessaries gently press against the pelvic wall to stop pee leaks when a woman coughs, sneezes, or laughs.

See below for an image of Uresta inserted into the vagina. The bell shape of Uresta works to press up against the urethra through the vaginal wall to prevent leaks from occurring during moments of extra pressure (like coughing, sneezing or jumping).

Can’t I just do Kegels? Or use a tampon?

Unfortunately, pelvic floor strengthening exercises such as Kegels are not enough to completely eliminate pee leaks for many women. Kegels may be enough to decrease pee leaks during daily activity but it is often not enough for more intense activity such as workouts or running. Sometimes you just need a little extra support! Pessaries act like a sports bra or ankle brace for your bladder. Pessaries can be a great compliment to pelvic floor strengthening, and many pelvic floor physiotherapists actually recommend doing Kegels in conjunction with Uresta.

While tampons and pessaries are both inserted into the vagina, they serve completely different functions. 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 by a tampon is not significant enough to meaningfully reduce or stop their leaks. Uresta on the other hand is specially designed to provide direct support to the urethra to stop bladder leaks! 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.

Downfalls of existing pessaries

While existing pessaries are a less invasive treatment for urinary incontinence than surgery, they are far from perfect.

Doctor appointments: Traditional pessaries require a physician prescription as they need to be inserted by a medical professional, as it may cause vaginal damage or be ineffective if fitted incorrectly.
Loooong waitlists: Waitlists, especially after the pandemic, can be very long. Average waitlists to see a physician in Canada to get fitted for pessary is 6 to 12 months in most provinces.
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 insertion: Depending on the type of pessary used, many have to be lubricated or moistened before insertion into the vagina, making it difficult to re-insert, especially when not in the comfort of your own home. Pessaries also have to be inserted deep into the vagina, causing discomfort for many users. Many women may need to purchase an additional tool to assist with extracting a pessary.

Why is Uresta better?

  • Self-managed: Unlike traditional pessaries, Uresta is available over the counter. This means you don’t have to go to a doctor to get fitted or for upkeep – we offer 3 sizes that work for over 80% of women. You can try Uresta in the comfort of your home without the pressure of a physician visit.
  • No long waitlists: 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. This also makes it more comfortable!
  • 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!

Curious to learn more about pessaries? Or perhaps you are a visual learner?

Check out this video from Be Pelvic Health Aware on pessaries.