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Updated: Aug 8, 2026

Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula
Published on: April 14, 2026
Management of the neglected vaginal ring pessary
Ruwan J Fernando1, Abdul H Sultan, Ranee Thakar
1Urogynecology Unit, Department of Obstetrics and Gynecology, Mayday University Hospital, Croydon, Surrey, CR7 7YE, UK.
Abstract:
We present two cases of vaginal pessaries left in situ for prolonged periods and subsequent impaction that were managed differently. One was partially epithelialized and removed in the outpatient clinic by a new technique whereby the ring pessary was divided by a bone-cutter and passed through the epithelial tunnel without anesthesia. The second, which was a completely epithelialized metal ring pessary, was removed under anesthesia. Resulting fibrosis can cure the prolapse.
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The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
