Pessary Management
Pessaries can be an effective non-surgical approach to management of some pelvic floor conditions including prolapse and urinary incontinence. Not all patients are suitable for a pessary, and some patients may prefer not to use or try one. Your specialist urogynaecologist will help you understand your choices.
All our doctors are trained to understand if a pessary is suitable for you and, if so, which option might be best for you and your condition. Our doctors are likewise trained in pessary fitting.
The care of established pessary patients is managed by our specialist gynaecology nurse Lucy Tiralongo in our Pessary Management Clinic. Lucy is a qualified Clinical Nurse Specialist and continence nurse with many years of experience in public and private urogynaecology, including the Royal Women's Hospital (RWH) pessary service. Lucy is trained in pessary management including pessary changes, recognition of pessary complications and cervical screening if needed. Lucy can also provide lessons for patients in pessary self-care and self-management of pessaries if desired.
Whilst your pessary check appointment might be with Lucy, your specialist urogynaecologist is your treating doctor and will co-ordinate your ongoing care.
FAQ
How often should pessaries be checked?
The frequency of examinations and check-ups is individualised; however, as a general rule we recommend checks approximately every 6 months for patients who do not self-manage their pessary, and approximately once per year for patients who regularly remove their pessary themselves.
Can I self-manage my pessary?
Absolutely — there's no right or wrong here. Around half of women self-manage their pessaries and around half don't. The reasons vary for both management options. Our nurse Lucy can work with you to find the solution that best fits your lifestyle and the type of pessary your doctor has fitted for you.
Is a pessary something I can use forever?
If you have successfully been fitted with a pessary, it can in some cases be a long-term management option. This is more likely to be possible if you have regular check-ups and review to ensure no problems associated with the pessary have occurred.
However, in many cases women find pessaries most helpful for the short to medium term. Patients may then decide to proceed to surgery when they feel ready and the benefits of surgery might be right for them at that point. It's really all about the individual patient — our nurse and doctors' roles are to help support your choice and give you advice.
What is the benefit of being seen in the pessary management clinic with our specialist nurse?
Other than Lucy being absolutely delightful, appointments with Lucy nearly always run to schedule, so you can be more sure that your waiting time on the day will be minimal. Additionally, appointments with Lucy have extra time allocated for pessary lessons and education if you require it.
We charge slightly less for review appointments in our pessary clinic with our nurse compared to our standard review with our doctors, in recognition of this different service. Of course, if Lucy or you have clinical concerns, our doctors are still co-ordinating your care, and you can always move back to review with your doctor at any time if you prefer.
Is the pessary covered by Medicare or DVA? Is there a discount for pensioners/HCC for the pessary?
Pessaries are not rebatable through Medicare. We will invoice you on the day for any new pessary you might need, and payment is expected at the time of your appointment. We have a set price for pessary sales and unfortunately can't offer a discount for pensioners or HCC.
I have been seen by the nurse in the pessary clinic for the past few years, but now I think I might be ready to consider surgery. How do I arrange this?
Your care in the pessary management clinic has always been co-ordinated by your treating urogynaecologist. If you think you would prefer to consider surgery, it's as simple as discussing this with Lucy at your next appointment — she will arrange any preoperative assessment you might need and liaise with your specialist. Alternatively, you can contact our reception team and request a surgical planning review with your specialist. Our mission is to provide ongoing care that is centred around you and what your goals are.