Updates in Pessary Care for Pelvic Organ Prolapse: A Narrative Review

Pelvic organ prolapse (POP) affects millions of women globally, significantly impacting quality of life. Pessaries serve as a first-line, non-surgical option for symptom relief, particularly among women who wish to avoid or delay surgery. Despite widespread use, challenges persist in fitting, patient education, and long-term adherence, necessitating further advancements in design and care protocols. This narrative review was conducted to explore the role of vaginal pessaries in the management of POP, focusing on efficacy, patient adherence, complications, and emerging innovations. Pessaries demonstrate high initial success rates, but long-term adherence varies. Improper fit, discomfort, and lack of self-management contribute to discontinuation. Complications, including vaginal discharge, erosion, and bleeding, are common but generally manageable. Recent innovations, such as self-removable pessaries, 3D-printed custom designs, and hormone-releasing pessaries, show promise in improving patient experience and adherence. Studies support self-management as a cost-effective strategy that enhances patient autonomy and reduces clinic visits. Pessaries remain a valuable conservative treatment for POP, yet challenges in long-term adherence highlight the need for standardized fitting protocols, better patient education, and continued innovation in design. Future advancements should focus on patient-centered, user-friendly solutions to enhance effectiveness, comfort, and self-care, ultimately empowering women with more accessible and sustainable pelvic health options.