inserting the club pessary
1. Lubricate only the entering end of the pessary.
2. Use one finger to depress the perineum.
3. Guide the pessary, inserting it edgewise almost parallel to the introitus, avoiding the urethral opening while the perineum is strongly pushed downward. Use a corkscrew motion while introducing the CLUB PESSARY into the vagina.
Once the large flat disc is past the introitus, push the pessary upward until only the end of the stem shows in the vaginal
entrance. The cervix rests behind the flat disc.
5. Have the patient sit, stand and bear down. Examine the patient while she is in the standing position to ensure the pessary has not shifted position. The patient should not feel the pessary once it is in position. The pessary should not be too loose as it may turn or be expelled and it should not be too tight as it may cause discomfort.
6. The healthcare professional should be able to sweep one finger between the pessary and vaginal walls. If there is not enough
space to do this, the next smaller size should be tried. If excessive space exists, the pessary will not be effective and may rotate or even be expelled.
7. It may be necessary to refit the patient with a different size or type of pessary after a period of time. Do not assume that a replacement will always be the same size as the previous one. Check the fitting to ensure continued patient comfort and relief of symptoms. The useful life of a pessary is limited. Examine frequently for signs of deterioration (such as cracks or breaks in silicone outer surface).
A pessary should be replaced if damaged.
Note: If the patient is unable to urinate with the pessary in
position, remove it and fit her with the next smaller size. Repeat as
8. If the patient can void without difficulty, pessary remains in position upon re-examination, and the patient is comfortable with the pessary in place, this is a good indication that the correct size may have been selected. Patient experience may vary.
9. Ulcerations and erosions frequently occur in cases of complete
prolapse due to irritation of the exteriorized cervix. Whenever possible, reducing the mass and treating the irritation are primary
steps before using a pessary. Prolapse reduction may resolve cervical vaginal irritation. Verification of cervical cytology (pap) and or biopsy as clinically indicated.
10. During each visit, the vagina should be carefully inspected for evidence of pressure or allergic reaction. The patient should be questioned concerning douching, discharge, disturbance of bowel function or urination. It may be necessary to fit another size or an entirely different type of pessary.
11. At the physician’s discretion, the patient can be instructed in the proper removal, cleaning and reinsertion techniques for her own pessary. This process can be performed nightly or even weekly by the patient under ideal circumstances.
removing the CLUB PESSARY
1. Use one finger to depress the perineum.
2. Use other hand to grasp the “knob,” pulling the pessary away from the cervix, turning the pessary so that the disc is almost parallel to the introitus. Using corkscrew motion ease the pessary out.
3. Removal may be facilitated by passing a finger
along the stem and behind the disk
If you can not empty your bowels or bladder after the CLUB PESSARY has been fitted, please seek medical help. It could be the CLUB PESSARY is too large for you.