BALANCE RING PESSARIES

A pessary, classified as a medical device, is designed for insertion into the vagina to address issues such as:

• Pelvic organ prolapse
• Urinary and fecal incontinence
• Preterm pregnancy

Available in various shapes, sizes, and materials; notable models include the ring, cube, and fungiform (Also known as - Gellhorn), typically crafted from medical-grade silicone or Polyvinyl Chloride (PVC).

For women who either prefer not to undergo surgery or face limitations in doing so, the pessary emerges as a practical alternative. Nevertheless, there are instances where the pessary serves as a temporary measure, bridging the gap until corrective surgery can be pursued.

Individuals opting for a pessary make a conscious decision to resume their regular daily activities, alleviating discomfort and pain discreetly. Specifically designed for women with an active sexual lifestyle and those engaged in sports, certain pessary models facilitate independent insertion and removal for added convenience.

A vaginal pessary is placed inside the vagina. It will stretch its walls and hold the soft tissues up, so as to prevent the uterus or the vaginal walls from bulging out of the vagina. Occasionally for patients with very weak pelvic floor muscles, the pessaries may not stay in place. Your doctor will discuss this with you.

Your esteemed healthcare professional will guide the selection of the appropriate model and size based on individual needs.

Typically, for prolapses up to the third degree, traditional ring pessaries are recommended.

In instances of prolapses exceeding the third degree and cystocele, the gynecologist may opt for alternative models such as the fungiform (CdF Gellhorn) or the cube. Additionally, in cases of preterm pregnancy, the perforated cervical model is deemed suitable. It is advisable to consult with your trusted specialist for personalized recommendations tailored to your specific requirements.

The accurate sizing and selection of the pessary model are determined by the specialist during the outpatient consultation. In order to ascertain the appropriate size for the patient, the gynecologist or midwife utilizes a pessary of dimensions slightly smaller than the vaginal entrance, ensuring the presence of a discernible space between the device and the vaginal wall, approximately equivalent to the thickness of a phalanx.

It is imperative that the patient remains devoid of any sensation from the pessary, and there should be no associated difficulties with urination. As a standard procedure to verify the secure placement of the pessary, it is advisable to simulate a series of coughs while in a supine position with legs apart on the footrests. Additionally, the patient is encouraged to walk for a few minutes within the clinic premises, followed by a reassessment of any potential impediments to urination subsequent to the pessary insertion.

The pessaries are designed for single patient use only. Currently, Balance Ring pessaries are available as:

• Balance PVC Ring Pessaries
• Balance Silicone Ring Pessary with Support
• Balance Silicone Ring Pessary without Support

The pessaries are designed for single patient use only. Currently, Balance Ring pessaries are available as:

• Balance PVC Ring pessaries are rounded, white in colour and soft
• Balance Silicone Ring Pessaries are rounded, transparent and softer than PVC pessaries

Special nurses, doctors and physiotherapists can put a pessary in place. You won’t need an anaesthetic because it’s usually not too uncomfortable.

Because pessaries come in a number of sizes and shapes, you may need to try a few before you find one that is comfortable and provides the right support.

In instances of prolapse and urinary incontinence, challenges to a woman's intimate well-being may arise. The associated discomfort and feelings of shame can potentially lead to social isolation, hindering one's ability to pursue a normal daily life and enjoy personal freedom.

In situations where surgical intervention may not be feasible, the pessary emerges as the singular alternative for restoring a sense of normalcy. Its application significantly impacts the psychological aspects of an individual, providing a viable solution to mitigate the associated challenges and contribute to an improved quality of life.

If you have a pessary that is the right size and in the right position, you won’t be able to feel it and you’ll be able to do all your normal activities. After the pessary has been inserted you can resume all of your normal day to day activity, including sexual activity. In fact the pessary should improve your ability to be active as it supports the prolapse and should make you feel more comfortable.

A pessary that is the wrong size can fall out but it cannot end up anywhere else in your body.

No, It is imperative that the pessary be replaced at regular intervals under the supervision of your gynecologist or your health care professional.

To ensure proper maintenance of the pessary, kindly rinse it under running water utilizing a neutral soap and a soft brush. Following the cleansing process, position it on sanitized surfaces, taking care to keep it shielded from dust and direct sunlight.

A pessary serves to ensure the uninterrupted pursuit of one's daily activities for women, without imposing limitations. Its use not only mitigates the discomfort and pain associated with prolapse but also addresses concerns related to incontinence, all while maintaining utmost discretion—No one including your partner will know you're wearing one!

We advocate for daily intimate hygiene employing a neutral intimate cleanser. Additionally, contingent upon approval from the specialist, we suggest the incorporation of weekly vaginal douching into the routine.

Yes, a ring pessary can be used during pregnency. some women find that as their pregnency progresses their symptoms of a prolapse resolve and a pessary is not required. If you become pregnant and have a pessary in place you can continue to use it.

Yes, as both Balance PVC and Silicone Ring Pessaries are metal free, they are safe to have X-Ray / CT Scan / MRI with.

If you already have an IUD in place, then you can have a pessary inserted. They will not, however, be able to insert an IUD if you have a pessary already in place. It will need to be removed and then re-insert once the IUD has been fitted.

Yes. You can use a tampon if you have a ring type pessary as long as it feels comfortable.

Yes. You may be offered self-management of your pessary by your healhcare professionl if suitable. You can manage your pessary yourself once you have been shown how to, have practiced and are confident to do so.

You may find it more comfortable to use a sterile lubricating gel like EasyLube when inserting a pessary, especially a new one, but you do not have to.

For Balance PVC Ring Pessaries: If there are no complications, as a guide & best practice, as a guide the minimal time for changing a pessary and replacing it with a new one is once every 6 months.

For Balance Silicone Ring Pessaries: If there are no complications, as a guide & best practice, the maximum time for changing and replacing the Balance Silicone Pessary with a new one is once every 2-3 years or earlier if it shows signs of cracking, loss of shape or flexibility.

Your doctor will schedule follow-up visits to fit the needs of the patent and in accordance with local guideline/policy or have a suggested following schedule:

• Have patient return within 24 hours for first examination.
• Have patient return for second examination within 3 days.
• Have patient return for examination every few months.

Periodically, the pessary needs to be replaced and the doctor will check it is working properly for you no later than every six months. You will have the opportunity to discuss any concerns you may have.

Note: The above schedule of follow-up examinations may be altered to fit the needs of the individual patient at the discretion of the healthcare provider.

Pessaries can become uncomfortable and occasionally fall out. If you experience any of the following side effects, they can be easily reversed by removing the pessary:

• An occasional increase in urinary incontinence due to the position of the pessary.
• A degree of vaginal discharge is normal, however you should not experience any unpleasant discharge.
• Potential bleeding as a result of an ulcer where the pessary has rubbed.
• The pessary has slipped and is no longer beneficial.

To avoid and reduce these risks, you will have regular check-ups to slightly alter the position of the pessary and check the health of the surrounding organs.

It is possible to buy online but it is not advisable without having been assessed by a trained professional who can make sure you have the correct and most suitable pessary. There are a large variety of pessaries on the market and an appropriately trained healthcare professional will be able to help you find one that is likely to help you and your specific prolapse and symptoms. If you buy one online, it would be advisable to ask a healthcare professional to check it is suitable for you before you use it.

Prolapse is characterized by the downward descent, and occasionally protrusion from the vaginal entrance, of various pelvic structures. This condition can manifest in different forms and levels, impacting::

• The uterus, leading to hysterocele;


• The bladder, resulting in cystocele;


• The rectum, causing rectocele;


• Intestinal loops, contributing to enterocele;


• The vaginal dome post-hysterectomy (removal of the uterus).

Uterine prolapse involves the downward displacement of the uterus from its normal position in the small pelvis to the vaginal canal. The condition is classified into four degrees:

• First degree: The uterus descends into the vaginal canal;


• Second degree: The uterus protrudes beyond the vulvar rim;


• Third degree: The uterus reaches the entrance of the vagina, emerging from the vulvar rim;


• Fourth degree: The uterus fully protrudes from the vaginal canal.

Prolapse is often marked by a feeling of pelvic pressure and a sense of weight in the vaginal area. In severe cases, it can lead to the protrusion of the uterus from the vagina, accompanied by symptoms such as urinary incontinence, cystitis, challenges in emptying the bladder, constipation, and bleeding—all indicative of compromised organ function.

Additionally, mild prolapse may not present noticeable symptoms, and some women may experience discomfort during sexual activity or a sensation of organ movement in the groin, especially with changes in position or during walking.

Uterine prolapse is typically identified through a routine gynecological examination. If issues related to urination and bladder emptying surface during the consultation, a urological examination may be advised by the specialist.

In the clinical interview, the gynecologist assesses the patient's specific circumstances, including factors like childbirth, menopause, and estrogenic deficiencies. The examination also takes into account potential risk factors such as obesity, chronic constipation, and underlying pathologies.

This disorder stems from a weakening of the pelvic floor, either total or partial, that normally supports the pelvic organs. Primary contributors to this weakening include childbirth and menopause. However, it can also result from factors such as chronic constipation, pelvic trauma, obesity, chronic bronchitis, decreased physical activity, and family-related issues.