How long should you leave a pessary in place between cleanings? There is no single correct answer. Some women wear a pessary only occasionally, or wear it during the day but take it out every night. At the other extreme, some women leave a pessary in place for weeks or months. Pessaries are designed to stay in place for weeks on end, allowing fluids to flow around them — even your menstrual flow — but frequent removal and reinsertion is perfectly safe and acceptable.
The good news: you have options! And you can work with your care provider to create a pessary care plan that works for you.
What Is a Pessary?
A pessary is a silicone device that you can wear at the top of your vagina to hold your pelvic organs in place. If you have pelvic organ prolapse (bladder prolapse, or cystocele; rectal prolapse, or rectocele; or a prolapsed uterus), a pessary can allow you to be active and comfortable without the pain and danger of surgery. If you have urinary incontinence, some pessary styles can help you get control.
Your Individual Preferences: Questions to Consider
How long do you want to wear your pessary? It’s a matter of personal preference.
Do you want your pessary to be only for especially active days, or every day? If you wear your pessary only occasionally, simply clean and store it between uses. If you want to wear your pessary every day, you have the option to remove and clean it daily, every few days, weekly, or only when you feel the need, leaving it in place the rest of the time (except at GYN visits for pessary care).
Does your pessary interfere with sex? If you’re sexually active, you can probably have sex — yes, including intercourse — with your pessary in place. Some pessary shapes will not allow this, but most will.
Can you remove and insert your pessary on your own? Some women don’t have the strength or flexibility in their hands to insert and remove a pessary, especially as they get older. Also, certain pessary shapes may be difficult for you to remove on your own. In that case, it’s perfectly OK to leave it in place 100% of the time between appointments with your health care provider.
What Health Care Providers Recommend
Health care providers will have different recommendations based on the way they were trained, and on their own observations. Ideally, your health care provider will use scientific evidence to guide your care. However, regarding the question of the ideal length of time to leave a pessary in place between cleanings, there is no scientific evidence. No-one has conducted a scientific study on this topic. (There’s no study I can find, anyway. If you know of one, please contact me!)
No matter how often you remove and clean your pessary at home, it’s important to have regular office visits with your health care provider so the vaginal lining can be examined. If you don’t remove your pessary yourself, but leave it in place except at health care appointments, these appointments may be especially important. Your pessary must be removed and cleaned at least as often as every few months.
Some providers want women to come to the office every month for pessary care. Others recommend an office visit every three months. I’ve even heard of one doctor who told one of my Kegel Queen members to leave her pessary in place and visit his office every five months. (Please note: that length of time is way outside my comfort zone and far longer than most practitioners recommend.)
What Pessary Manufacturers Recommend
Here are recommendations from two leading pessary manufacturers, Milex and Bioteque. Bioteque recommends daily cleaning, but also says it’s fine to leave the pessary in place for 4 to 12 weeks. Milex does not address home care, but recommends a followup visit with your health care provider every 4 to 6 weeks, noting that the schedule can be adjusted based on patient and physician preference.
So… How Often Should I Remove and Clean My Pessary, After All?
It’s up to you. You can remove and clean your pessary every day, or you can leave it in place as long as three months. Any pessary care schedule within those parameters can work well, as long as it works for you with the support of your health care provider.