The Smith Pessary is part of the Lever pessary family and an adaptation of the Hodge pessary. The Smith can be used to treat urinary stress incontinence, but it is necessary for the patient to have a well defined pubic notch.
The Smith pessary is helpful in cases of repeated miscarriages due to an incompetent cervix by repositioning the weight of the growing foetus.
The incompetent cervix in general points forward in the axis of the vagina. The Smith pessary redirect the cervix posteriorly, as in normal pregnancy.
As a result, direct pressure on the cervical os is reduced and aids in preventing premature dilation and/or membrane rupture. The Smith can also serve as a sling to help keep the head and fetus from descending and pressing on the internal os. (the internal orifice of the uterus = internal os)
Because of the shapeable wires, the pessary must be removed during x-rays, ultrasounds and MRI's.
Indication for use: Stress urinary incontinence for a woman who has a very small vaginal introitus. Helpful in cases of repeated miscarriage due to an incomplete cervix by repositioning the weight of the growing foetus.