Pessary Specialist
Dr. Daniel Stone, MD FACOG
Urogynecologist located in Phoenix, AZ
Dr. Daniel Stone, MD provides pessary fitting and management for patients in the Phoenix, Scottsdale and surrounding Arizona areas. Because pessaries are a non-surgical way to manage Pelvic Organ Prolapse and Stress Urinary Incontinence, patients can avoid the downtime of surgery and still have their symptoms managed.
Pessary Q & A
What is a pessary and what does it treat?
A vaginal pessary is a silicone device that is used to treat stress urinary incontinence and/or pelvic organ prolapse such as cystocele (bladder prolapse), uterine prolapse, vaginal vault prolapse or a rectocele.
How does a pessary work?
Dr. Stone will first find the right size and shape during a pessary fitting visit. Once the right size and shape are found, it is placed into the vagina and it will support the dropped pelvic organs. If it is used for stress urinary incontinence it will compress the urethra during activities that can cause leakage.
Is a pessary right for me?
If you have prolapse or stress incontinence, then Dr. Stone will discuss this option with you. Good candidates for pessaries are listed below:
- You need help with urine leakage with exercise
- You’d like a treatment but want to avoid surgery. Some may want to avoid surgery altogether and others may be looking for a short-term solution
- You’d like a treatment but have health problems that surgery too risky
- You’re considering a future pregnancy
How does Dr. Stone do a pessary fitting?
This is usually done at a separate visit. He will use the measurements that he took during the first visit to decide on an initial shape and size. He will then place the pessary. If it is uncomfortable, the pessary is too big and a smaller size or different shape is needed. He then will have you stand up and try different maneuvers to make sure that the pessary stays in place. If the pessary falls out, then it is too small and you will likely need a larger size or a different shape.
You then will “test” the pessary out for 1-2 weeks. At the 2nd visit, as long as it is working well, Dr. Stone will review how to remove and put it back in yourself.
How often does it need to be removed?
Dr. Stone will review this with you. Everyone is different but the most ideal situation is that you remove it nightly and leave it out overnight. However, this doesn’t work for everyone. Some women remove it weekly, some monthly. The longest interval of time that Dr. Stone is ok with, is removal every 3 months. This would be done under close supervision to make sure that the vaginal tissue remains healthy.
What are the side effects of pessary use?
The most common side effects are vaginal discharge, vaginal ulcers, and bleeding. These can be managed easily with trimosan gel, vaginal estrogen cream, or with a “pessary holiday”, where you leave the pessary out for 1-2 weeks. Talk to Dr. Stone if you experience any of these issues.
Pessaries can also be forgotten about which can lead to serious issues. Fortunately, this is very rare, but a forgotten pessary can lead to ulcers and fistulas, which are abnormal connections between the vagina and rectum, or vagina, and bladder.
How successful are pessaries?
Dr. Stone can find a comfortable size and shape for you 95% of the time. For prolapse, pessaries can successfully manage symptoms 90% of the time. For incontinence, pessaries can successfully manage symptoms 50% of the time.
How often do I need to see Dr. Stone with a pessary?
Dr. Stone will discuss this with you. If he is removing, cleaning and replacing it for you, then he would like to see at minimum every 3 months. If you are removing, cleaning and replacing yourself, then he would like to see you yearly. These intervals are gradually worked up to. For example, he’d fit the pessary, see you at 1-2 weeks, 1-2 months, 6 months, and 12 months if you are managing it yourself.
What is a ring pessary?
The ring pessary is usually the first one that Dr. Stone will try. They tend to be the easiest to remove and clean yourself. To insert it, the pessary is folded in half like a taco. One hand will spread the labia, and the other will guide the folded pessary into the vagina. Once the pessary is inside, it will unfold and support the pelvic organs.
To remove a ring pessary, a finger is inserted vaginally until the ridge of the pessary is felt. The ridge is then gently pulled out until the pessary is removed.
What is a gelhorn pessary?
The gelhorn pessary is usually the 2nd type of pessary Dr. Stone will try. These can be very difficult to remove by yourself. For most patients, removal takes place at regular intervals at Dr. Stone’s office. To remove he finds the knob of the pessary and gently pulls on it until the dish portion of the pessary can be reached. One finger is then used to break the seal of the dish portion and the vaginal tissue and the pessary can be removed.
What brand of pessary does Dr. Stone use?
Dr. Stone and his office usually use Milex Pessaries from CooperSurgical.
Testimonials
Major Insurance Providers Accepted
We accept most insurance policies for your convenience. Please contact your insurance carrier to verify your individual benefits and any copays or coinsurance that are part of your plan. Patients are responsible for notifying our office if a specific plan requires precertification, preauthorization, or a referral (especially HMOs). Please call the phone number on the back of your insurance card to verify your provider network participation as insurance carriers change policies often.
Schedule your appointment with Dr. Stone today
One of our staff members will contact you directly. If you have any concerns requiring immediate attention, please don’t hesitate to call us at 602-788-1521.
Office location
Valley Urogynecology Associates
Phoenix, Arizona 85016-1302
Office Hours: Monday-Friday from 8 AM – 5 PM
Main: (602) 788-1521
Fax: (602) 688-5420
Conveniently located just off Highway 51 on Maryland Avenue just East of 16th Street between East Bethany Home Road and East Glendale Avenue.