Review of vaginal pessaries

Pessaries have been used to treat pelvic organ prolapse throughout history, although with advances in the field of anesthesia and in surgical technique during the past century, pessary use declined. Current indications for pessary use include women awaiting definitive surgical repair, treatment for an unsuccessful surgical repair, treatment for women who are not surgical candidates, and for those who prefer medical management. In addition pessary use is gaining popularity among women with stress urinary incontinence, as well as in younger women interested in maintaining child bearing capabilities. Neonatal pelvic organ prolapse has also been treated successfully with pessaries. Many physicians have limited experience with pessary selection and fitting. This review article attempts to provide a basic overview of pessary selection and management.