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  • Jodi Forster-Molstad


What is a pessary?

A vaginal pessary is a device made of silicone that is inserted in the vagina to support and protect the vaginal tissues from pelvic organ prolapse. A pessary can provide a conservative, non-surgical option to help reduce the symptoms caused by a uterine, bladder or bowel prolapse. (To learn more about pelvic organ prolapse, see my previous blog: June is Pelvic Organ Prolapse Awareness Month @ https://www.pelvicplusphysio.com/blog). It does this by keeping the pelvic organs and the pelvic floor muscles in an improved position that facilitates a better pelvic floor muscle contraction.


Sadly, the symptoms of pelvic organ prolapse can make women avoid certain activities or exercises that they enjoy for fear of worsening their symptoms


A well-fitting pessary along with an individualized pelvic floor strength program can eradicate or minimize the symptoms of pelvic organ prolapse, including:

  • The sensation of a bulge at the vaginal or rectal opening that can be seen or felt, and that may change depending on position, physical activity, or bowel movements.

  • Heaviness or pressure felt in the perineal region (between the vagina and anus).

  • Incomplete emptying of or difficulty evacuating the bladder or bowels.

  • Difficulty initiating urination.

  • Pain is not typically a defining characteristic of prolapse.

Pessaries are also used to prevent the progression of a prolapse and in certain cases will help relieve urinary and/or fecal incontinence.

Pessaries come in different shapes and sizes. Your doctor or your pelvic health physiotherapist with specialized training in pessary fitting is able to determine the best type and fit for you. Their aim is to reduce the symptoms of heaviness in the pelvic region, incontinence, etc, without feeling the pessary itself. A pessary should never cause vaginal discomfort or pain while it is being worn.


A pessary will last for 2-3 years. It is important to have regular follow-ups with a pelvic health physiotherapist or your doctor to ensure there is no injury or tissue erosion occurring. It is important to make the more frequent follow-ups initially and then on an annual basis to ensure that the vaginal tissues are tolerating the pessary well. It is also important that the pessary user is able to insert, remove, and perform the proper hygienic procedures for that specific pessary.

This is something a pelvic health physiotherapist with the training is able to teach you.


Interested in knowing more? I can be reached by email or phone contact, click on the contact tab at the top of this page. I am ready to answer your questions about pessary use for pelvic organ prolapse.


Pessary fitting is a service that is provided at Pelvic Plus Physio!




PELVIC PLUS PHYSIO - HELPING YOU FIND FREEDOM IN MOTION!


  • Jodi Forster-Molstad

Did you know that 33-50% of women will have some form of pelvic organ prolapse in their lifetime, and most have never even heard of it?⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀

Pelvic organ prolapse can be defined as the descent of the pelvic organs (the bladder, urethra, uterus, vagina, rectum, or small intestine) toward or through the vaginal or anal opening. Some women with pelvic organ prolapse have no symptoms at all, and some will experience:⠀⠀⠀⠀

  • A bulge at the vaginal or rectal opening that can be seen or felt and that may change depending on position, physical activity or bowel movements.

  • Heaviness or pressure felt in the perineal region (between the vagina and anus).

  • Incomplete emptying of or difficulty evacuating the bladder or bowels.

  • Difficulty initiating urination.

  • Pain is not typically a defining characteristic of prolapse.

There are different degrees of severity of pelvic organ prolapse, that can be identified by a grading system such as the one below.


Baden–Walker half way system [6]. It consists of four grades: grade 0 – no prolapse, grade 1–halfway to hymen, grade 2 – to hymen, grade 3 – halfway past hymen, grade 4 –maximum descent.

While a woman with minimal prolapse may experience no or relatively minimal symptoms, the severity of a woman's symptoms increase along with the grade of organ descent. When a woman presents with a relatively minor grade of prolapse, they will tend to respond quite well by making lifestyle modifications that ensure good bowel health, activity modifications and a progressive pelvic floor exercise strength program. As the pelvic organ prolapse goes up in grade of severity, so does the need for intervention required to help manage the symptoms. Other options include the use of a vaginal pessary that is inserted vaginally to support the organs, or by surgical intervention. Vaginal pessaries offer a less invasive option than surgery, and it is advised that a woman complete 3 months of pelvic floor exercises before deciding on either option.


For more information about pessaries, see my next blog: A Pessary: what is it good for?


Pelvic health therapists can examine a woman and identify the type and grade of pelvic organ prolapse that she has, and help her determine the best plan of care to eradicate, minimize, or manage pelvic organ prolapse. Some pelvic health therapists who have the training and special equipment needed are able to offer a pessary service. They can determine the right type and size of vaginal pessary for a woman, provide them with a pessary, and teach them how to properly care for and mange a pessary to ensure good vaginal health is maintained.


If you are experiencing any of these symptoms and want to learn conservative options, ask your pelvic health physiotherapist to determine what the best treatment plan is for you.


PELVIC PLUS PHYSIO - HELPING YOU FIND FREEDOM IN MOTION!


  • Jodi Forster-Molstad

I am incredibly pleased to say that beginning on Monday, June 1st the clinic will be open for in-person appointments! The restrictions were lifted on May 27, 2020, and the College of Physiotherapists of Ontario published their guidelines for resuming a graduated, safe return to in-person appointments. I would like to express my gratitude to the amazing health care workers, the community, and my patients for their dedication and patience during the COVID-19 pandemic. I am also grateful to be able to do what I love once again and see all of you:)


Virtual care will remain available during this transition period and beyond. In order to ensure all of our health and safety, there will be additional infection control practices in accordance with these guidelines.

I am currently taking bookings for both previous and new clients for in-person and virtual appointments.

Please read through the directions below so you know what to expect when booking your next appointment:

  1. PRE-SCREENING: There will be mandatory screening for all patients and the therapist on booking of appointments and on arrival to the clinic. In-person care at the clinic will be provided when you and the therapist have decided that the benefits outweigh the risks.

  2. FACEMASKS & PERSONAL PROTECTIVE EQUIPMENT (PPE): Please wear a mask to the clinic if you have one. A surgical or cloth mask is fine. If you do not have a mask, you will be provided with one. I will also be wearing a mask and gown.

  3. ON ARRIVAL & DURING TREATMENT: On entering the clinic, please immediately wash your hands in the bathroom directed to the right. You will then be taken directly to the treatment room. Please do not bring extra people to the appointment unless necessary. There will be hand sanitizer in the reception and treatment room.

  4. STAGGERED TREATMENT TIMES & PUNCTUALITY: Treatment times will be staggered to prevent patients from crossing paths in the common area, and to allow for extra time between appointments for the additional sanitization procedures to be performed. It is therefore important to be on time for your appointment. If you are running late for your appointment, please call ahead to determine the best plan of action before entering the clinic.

  5. INCREASED SANITIZATION: In addition to routine cleaning, all surfaces that have come into contact with the patient and therapist will be sanitized with hospital grade sanitizer that has been approved by Health Canada.

  6. PATIENT DOCUMENTS: Whenever possible, patients will be asked to print and complete questionnaires and forms prior to coming to the clinic to prevent the need to share writing materials. These can either be returned electronically or brought to your actual appointment.

I am greatly looking forward to seeing you all again, and to helping you back on your path to achieving your health goals in the safest way possible!

Please contact me by email @ jodi.pelvicplus@gmail.com, phone @ 613-733-1638 or at https://www.pelvicplusphysio.com/ to see if you are appropriate for an in-person appointment.


Very best regards,


Jodi Forster-Molstad, PT

Clinic Owner, Physiotherapist


THE CLINIC

Address:  881 Plante Drive, Ottawa, ON, K1V 9E3

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CONTACT

Tel: 613-733-1638

Email: jodi.pelvicplus@gmail.com