Entrapped vaginal pessary presented with frequency and urge incontinence

Pessaries remain helpful for patients with genital prolapse who refuse or are not able to have surgery due to medical complications. It is generally considered both conservative and safe to wear a vaginal pessary. Only a few cases of severe complications have been reported whereby most result from a neglected pessary. We present a patient with extreme frequency and urge incontinence with recovery following the removal of the entrapped pessary. An 82-year-old oriental female carrying a vaginal pessary for more than 10 years had suffered from intractable frequency and urge incontinence for 6 months. The urinary analysis and urodynamic studies showed no sign of lower urinary infection or outlet obstruction. Physical examination found a black ring pessary in the vagina which could not be mobilized due to its deep embedment. The lower urinary tract symptoms were recovered after surgical removal of the pessary. Complication of a vaginal pessary may be caused by an ignorant patient or doctor. Frequency and urge incontinence could be an early sign of a severe complication due to a neglected pessary.