Vaginal pessaries for pelvic organ prolapse: a clinical selection guide

Treat the patient’s symptoms

Pelvic organ prolapse may cause a bulge or pelvic pressure and may coexist with urinary or bowel symptoms. Assess impact on daily life alongside examination findings. Not everyone needs an intervention. RCOG guidance describes conservative and surgical options.

Why consider a pessary?

A vaginal pessary provides mechanical support while in place. It may suit patients avoiding or awaiting surgery, those considering future pregnancy, or those with increased surgical risk. It does not permanently restore pelvic support tissues. Discuss care requirements and follow-up alongside expected symptom relief.

Match shape and care needs

Bioteque pessaries include rings, supported rings, Gellhorn, Donut, Cube and incontinence-oriented designs. Shape, support features, stem length and size all matter. An incontinence design is not a treatment for every type of leakage. Use the exact model’s instructions and individual clinical assessment. Manufacturer catalogue

Fitting is a process

Assess the prolapse, vaginal tissue, urinary and bowel symptoms and capacity for care. More than one fitting attempt may be necessary. Check comfort and retention; reconsider shape as well as size when fitting is unsuccessful.

Plan removal and review

The general Bioteque IFU advises daily removal and cleaning, with weekly removal at the physician’s discretion, and early assessment within 24–48 hours. Model-specific instructions take precedence. A clinic review interval must not be interpreted as permission for uninterrupted wear. The 2026 UK guideline provides an additional clinical reference.

Recognise problems early

Assess new bleeding, pain, unusual discharge, expulsion or voiding difficulty. Urinary retention, severe pain, fever or heavy bleeding require urgent assessment. Active genital or pelvic infection and inability to follow the care plan are contraindications in the general Bioteque IFU. Document the exact device and a realistic care plan. This article supports professional assessment; patients should not select or insert a pessary from website instructions alone.