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Vaginal pessary treatment of prolapse and incontinence

Jeffrey L Clemons, MD, FACOG
Section Editor
Linda Brubaker, MD, FACOG
Deputy Editor
Kristen Eckler, MD, FACOG


Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions, with prevalence rates of 25 to 65 and 20 to 55 percent, respectively [1-6]. Surgical repair is one approach to treatment: Approximately 200,000 women undergo surgery for POP and 135,000 women undergo surgery for SUI annually in the United States [7,8], and approximately 11 percent of women undergo surgery for POP or SUI by age 80. However, some women may prefer to avoid surgical treatment or may not be candidates for surgery. Vaginal pessaries are intravaginal support devices that may be controlled by the patient, reduce prolapse or incontinence, and are an alternative treatment option for women with these conditions.

This topic will review the various types of vaginal pessaries and their indications for use. Additional review of POP and stress SUI is presented separately. (See "Pelvic organ prolapse in women: Epidemiology, risk factors, clinical manifestations, and management" and "Treatment of urinary incontinence in women".)


A pessary trial can be offered to all women with pelvic organ prolapse (POP) or stress urinary incontinence (SUI), regardless of patient characteristics. Clinical settings where pessary use should be considered include:

Patient preference for nonsurgical treatment.

Presence of severe medical comorbidities that make the patient a poor surgical candidate.


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Literature review current through: May 2017. | This topic last updated: Apr 21, 2017.
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