Welcome to our Pessary Clinic! Pelvic health physiotherapists have many strategies, exercises, and innovations to help patients solve their pelvic health problems. One such option we have as physiotherapists in Canada is to fit patients with an internal medical support device called a pessary.
A pessary is a removable medical device made of silicone that supports the vaginal wall and pelvic organs. Pessaries can help symptoms of pelvic organ prolapse (symptoms such as heaviness, pressure, and bulging tissues) and stress urinary incontinence (leaking urine with activity, or when sneezing or coughing).
There are a variety of pessary shapes and sizes. Finding the right pessary is dependent on your symptoms and what is revealed in the exam. During a Pessary Fitting appointment, your physiotherapist will trial different shapes and sizes and recommend the right pessary for you.
Sometimes a pessary is desired by a woman as a non-invasive alternative to surgery to help manage symptoms of pelvic organ prolapse and/or urine incontinence. For some women, surgery is not an option due to their health status or for their own personal reasons. For others, a pessary is a good interim option while they wait to have surgery as it can take several months to have a surgical consult and surgery date.
You do not need a doctor’s referral to come for to our Pessary Clinic. It is also important to have any medical reasons why you should not wear a pessary cleared by your physician. Your doctor should confirm that your vaginal tissues are healthy so you can wear a pessary and you need to make a yearly plan to see your doctor for vaginal tissue health checks to make sure your tissues are tolerating the pessary well. Physicians can also prescribe vaginal estrogen, which provide support to your tissues.
Effective communication between your physiotherapist and physician is vital. Prior to your appointment, you may ask your physician to complete our Pessary Referral note Lakeview Pessary Clinic Referral Form. After your appointment, with your permission, we will also send a communication note to your doctor, so they know what our clinical finding are and which pessary you have.
A pessary is a safe device that you learn to insert and remove on your own. Complications and side effects can be avoided if you follow the recommendations given by your pelvic health physiotherapist and your doctor. The most common symptoms associated with pessary use include increased vaginal secretions or at times, very mild spotting. However, more serious side effects can happen, such as vaginal tissue chafing and infection. That is why it is especially important that you know how to remove the pessary, use good cleaning procedures, and know when to seek medical care. Using a vaginal moisturizer or prescribed vaginal estrogen can reduce these risks.
While pessaries can be used in pregnancy to help with pelvic organ prolapse, a gynecologist or more specialized medical centre would be the team to help fit a pessary in this case. Pelvic health physiotherapists at this time, are not able to fit women for a pessary during pregnancy. We can, however, continue to provide pelvic health physiotherapy treatment to you during your pregnancy.
If you are menstruating, the pessary can be used during your cycle, but you may not use a tampon or menstrual cup at the same time as the pessary. Pessaries can be safely used if you have an IUD. Most pessaries would need to be removed for intercourse, but the ring or oval style pessary may be left in for vaginal intercourse, if comfortable.
To be fit with a pessary at our clinic you must be willing to self manage your pessary and follow care recommendations. We take time to make sure you can insert and remove the pessary on your own. We teach you how to clean the pessary and to be aware of any complications. At Lakeview Pessary Clinic, we keep the most popular pessaries that we typically use in stock. That means you can usually go home on the same day as your fitting trial with your own pessary, providing relief of your symptoms immediately.
If you are attending for only a pessary, we usually see you twice: once for the assessment and fitting trial, and a follow-up to check that the pessary fit and function is good and that you can effectively self-manage. At that point, you can return to your regular pelvic health physiotherapist for continued treatment if required. If you do not have a pelvic health physiotherapist, we are happy to provide other treatment for you to supplement your pelvic health.
Using a pessary plus rehabilitating your pelvic floor muscle tone, strength, and endurance allows for a more comprehensive treatment plan. Combining the skills of pelvic floor physio and pessary fitting, provides the unique vantage point to successfully treat and manage pelvic organ prolapse and urinary incontinence.
Our pessary fitting services is considered physiotherapy when administered by a registered physiotherapist. We direct bill your insurance plan for the pessary fitting assessment and follow ups if you have coverage for physiotherapy. The cost of the pessary itself is not considered physiotherapy, but you are welcome to contact your insurance provider to determine if they will cover the costs as a medical device. Our pessary fitting services are not covered by Alberta Health Care Funding.
Contact us directly to book your appointment.