A Question about Pessaries

  1. I have been lecturing on female reproductive disorders and mentioned the use of a pessary for prolapsed uterus and bladder. One of the students asked--how long should a pessary be left in place before being removed and cleansed??? I have had VERY little experience with these devices and didn't know. (I know in one hospital in which I worked, a patient presented who had left a pessary in place for FIVE YEARS without touching it---YICCHH!!!) Does anybody out there have any experience with pessaries and know the recommended intervals that they are to be removed and cleansed?? (Or any other info about these devices that would be of interest???)
    Thank you for your assist. :kiss
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  2. 22 Comments

  3. by   OBNURSEHEATHER
    I wish I could help ya Vicky! Truth be told, I'm interested in your responses also!

    I had a post partum patient a couple of months ago that c/o feeling something "coming out" when she stood up, sat on toilet, etc. Yup. That baby was just hanging out!

    Anyways, a pessary was the route the doc discussed with the pt. I've been meaning to investigate it more since then, because it was something I hadn't even heard of.

    Heather
  4. by   baseline
    LOL...I didn't know they were still being used !!
  5. by   adrienurse
    I am by no means an expert, but it depends on the type. I know of some that can be left in for 3 months. I work with a nurse incontinence advisor who fits people for pessaries and scheduals appointments to change them. I suspect gynecologists do this as well. Very NB that estrogen -- either either topical, oral or in situ ring needs to be used to decrease irritation at the site.

    PS She told me a horror story of a woman that had forgotten about hers and it had become embedded into her uterine wall. Ouch!
  6. by   P_RN
    http://www.ucsfhealth.org/adult/edu/...tpessaries.pdf
    Caring for a pessary is easy. Pessaries can be left in place for up to a week and removed for periodic easycleaning. Some women choose to remove the pessary nightly before bed and replace it in the morning.
  7. by   sunnygirl272
    Originally posted by P_RN
    http://www.ucsfhealth.org/adult/edu/...tpessaries.pdf
    quote:
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    Caring for a pessary is easy. Pessaries can be left in place for up to a week and removed for periodic easycleaning. Some women choose to remove the pessary nightly before bed and replace it in the morning.
    --------------------------------------------------------------------------------
    __________________
    not to be rude, and not to say that pessaries are for the old ladies...but....the few clients that i have run across that have them..htere is no way on this green earth that they could..or would..be able to take them out...properly clean..and then properly reinsert...i am now having daymares about this thought,...
  8. by   Jenny P
    Way back 30+ yrs. ago when I was a County Health nurse, I had a 96 yr. old lady who had a severe uterine prolapse (are they graded? I seem to remember that it was a grade IV prolapse). Anyway, she had an inflatable pessary that I had to teach how to put it in, inflate with a little bulb (like the hand pump for inflating a BP cuff), then unscrew the bulb and remove that. She was to remove it and clean it and re-insert it once a week; the tricky part for us was to know when it was inflated enough-- until she pumped it up far enough, it would fall right out again when she'd stand up or strain a bit. That was a bit disconcerting because she complained it felt like she was giving birth when she least expected it! BUT she still walked at least a mile a day and was in excellent shape for her age (no modern conveniences in HER house! She still had a wood stove, a hand pump for water, and an outhouse!).
  9. by   VickyRN
    Thank y'all very much!!! I knew I could depend on my ALLNURSES family for help!!! BTW, P_RN, you are awesome!
  10. by   RNsweetie
    Thank you all so much. I learn so much from this site. I know where to come if I have any questions. you all are great.
  11. by   jenac
    I work in an LTC facility where we have a lady who has a pessiary. The order is for it to be removed every three months and cleaned, than replaced.
  12. by   sjoe
    jenac--does the order also say "whether it needs it or not?" Just a thought.
  13. by   jenac
    The order reads to be done q 3 months.
  14. by   caroladybelle
    UUUHHHH,

    I've had a dementia pt (or two) admitted to the hospital that no one(including the long term physician) knew that they had they had a pessary in place until it showed up on an x-ray.

    Trying to find that nasty little string after seeing it on the xray -icky!!!

    PS. How many have dealt with the "country" patients that use potatoes or other root vegetables for pessaries?

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