PELVIC pessary fitting

Non-Surgical Support for
Pelvic Organ Prolapse and Incontinence

At Resolution Physiotherapy & IMS Clinic in Barrie,
our Pelvic Health Physiotherapists have specialized training in the
sizing and fitting of Pelvic Pessaries
which can help provide vaginal support and improve symptoms of
Stress Incontinence and Pelvic Organ Prolapse.

Urinary incontinence and Pelvic Organ Prolapse are significant issues which are not discussed nearly enough.

1 in 3 women will experience some form of Incontinence in their lifetime

30-40% of women between 20-59 years of age will experience anatomical Pelvic Organ Prolapse
and 4-12% of women with have symptomatic Pelvic Organ Prolapse in their lifetime

If you are experiencing these problems,
you are not alone and a custom fit Pelvic Pessary may help!

What is a Pelvic Pessary?

A pelvic pessary is a soft, medical-grade silicone device inserted into the vagina to support the pelvic organs, including the bladder, uterus, and rectum.

It can help relieve symptoms such as:

• A feeling of pelvic heaviness or pressure

• Bulging or discomfort in the vaginal area

• Urinary leakage, urgency, or incomplete emptying

• Discomfort during activity, lifting, or exercise

When properly fitted by a trained professional, a pessary is discreet, comfortable, and allows you to continue your usual daily activities, including exercise and intimacy.

Who Can Benefit from a Pessary?

A pessary may be recommended for individuals of any age experiencing:

• Pelvic organ prolapse (any stage)

• Stress urinary incontinence

• Postpartum or menopausal pelvic support changes

• A desire to avoid or delay surgery

Pessaries are often combined with pelvic floor physiotherapy to strengthen the muscles that support your pelvic organs, creating a comprehensive and effective care plan.

Understanding Pelvic Organ Prolapse

Pelvic organ prolapse (POP) occurs when one or more of the pelvic organs shift downward into the vaginal canal due to weakened or stretched pelvic floor support.

It’s a common condition, especially after childbirth, during menopause, or following hysterectomy. The type of prolapse depends on which pelvic organ has dropped and where the support has weakened.

Types of Pelvic Organ Prolapse

1. Anterior Wall (Cystocele, Bladder Prolapse)
A cystocele occurs when the bladder drops into the front wall of the vagina. It is the most common form of prolapse and often leads to symptoms such as urinary frequency, urgency, leakage, or incomplete bladder emptying.

2. Posterior Wall (Rectocele, Enterocele)
A rectocele happens when the rectum bulges into the back wall of the vagina. It may cause sensations of pressure, difficulty with bowel movements, or the feeling of a vaginal bulge that worsens with straining.
An enterocele occurs when a loop of the small intestine drops into the upper portion of the vaginal canal, typically after hysterectomy. It can create a deep vaginal pressure or “dragging” sensation, particularly after standing for long periods.

3. Uterine Prolapse (Vaginal Vault, Cervical)
Uterine prolapse occurs when the uterus descends downward into the vaginal canal due to laxity in the uterine ligaments and pelvic floor muscles. Symptoms often include heaviness, pelvic pressure, and visible or felt descent within the vagina.

Stages of Pelvic Organ Prolapse

Pelvic organ prolapse (POP) staging is a way for healthcare providers to describe the severity or degree of descent of one or more pelvic organs (such as the bladder, uterus, or rectum) into the vaginal canal.

Staging helps guide treatment decisions, from conservative care (like pelvic floor physiotherapy and pessary use) to more medical or surgical treatment options if needed. It also allows your healthcare provider to track improvement or progression over time.

Prolapse staging is typically assessed through a pelvic exam, where your clinician evaluates how far the pelvic organ moves downward when you strain or bear down.

The most common grading system used is the Pelvic Organ Prolapse Quantification (POP-Q) system, though simplified versions (Stage 1–4) are often used in clinical practice.

Stage I

The organ drops slightly but remains well within the vagina. Symptoms may be mild or unnoticed.

Stage II

The organ descends closer to the vaginal opening, often causing a feeling of heaviness or pressure.

Stage III

The organ protrudes to or slightly beyond the vaginal opening. Symptoms are more noticeable and may interfere with activity or comfort.

Stage IV

The organ moves outside the vaginal opening. This stage typically requires medical attention.

Even in early stages, prolapse can affect bladder, bowel, or sexual function, and early management is key. Many people find significant relief through pelvic floor physiotherapy and pessary use, which can reduce symptoms, prevent progression, and often help avoid the need for surgery.

Understanding Stress Incontinence and Pessaries

Stress urinary incontinence (SUI) occurs when there is unintentional leakage of urine during physical activity, coughing, sneezing, or laughing. This happens when the pelvic floor muscles and connective tissues that support the bladder and urethra are weakened or stretched.

Certain pessary types — such as continence pessaries or ring pessaries with support — provide gentle lift and positioning to the urethra and bladder neck, helping them stay closed when abdominal pressure increases.

This mechanical support helps:

• Reduce or eliminate leakage during activity

• Stabilize the bladder and urethra

• Enable confident movement and exercise

• Work synergistically with pelvic floor physiotherapy for long-term improvement

Pessaries are a non-invasive, reversible, and effective option for managing stress incontinence, especially when paired with pelvic floor muscle retraining and lifestyle modifications.

What to Expect During a Pessary Fitting at Resolution Physiotherapy

Your appointment will be conducted by a Registered Pelvic Health Physiotherapist in Barrie with specialized training in pessary fitting and pelvic floor care.

During your visit, your physiotherapist will:

1. Perform a private, detailed pelvic health assessment.

2. Discuss your goals, comfort preferences, and activity level.

3. Select and fit the most appropriate pessary type and size.

4. Teach you how to insert, remove, and care for your pessary.

5. Schedule follow-up appointments to ensure continued comfort and effectiveness.

Your care is provided in a private, supportive environment, focused on helping you feel informed, comfortable, and in control of your pelvic health.

Why Choose Resolution Physiotherapy in Barrie?

• Experienced Pelvic Health Physiotherapists: Advanced training in pelvic floor rehabilitation and pessary fitting.

• Collaborative Care: Coordination with your physician, gynecologist, or nurse practitioner for complete support.

• Personalized Treatment Plans: Tailored to your specific type and stage of prolapse, symptoms, and goals.

• Trusted in the Barrie Community: Providing evidence-based care for pelvic health and non-surgical prolapse management.

  
  

Pelvic Organ Prolapse & Stress Incontinence FAQ

1. Can I exercise with a pessary?
   Yes! Many people find that a pessary allows them to exercise more comfortably by reducing pressure and heaviness. Your physiotherapist can guide you in safe and effective movement strategies.

2. Can a pessary help with bladder leakage?
   Absolutely. Certain pessary types provide support under the urethra, reducing stress incontinence during physical activity, coughing, or sneezing.

3. Does a pessary help all types of prolapse?
   Yes, pessaries can be fitted for cystocele, rectocele, uterine prolapse, or enterocele, offering customized support for each condition.

4. Is a pessary a permanent solution?
   Not necessarily. Some use a pessary temporarily, postpartum or during pelvic floor strengthening, while others use it long-term for consistent support.

5. Does a pessary hurt?
   A properly fitted pessary should not cause pain or discomfort. It should feel supportive but not intrusive.

6. Can I manage my pessary on my own?
   Yes, many people learn to insert, remove, and clean their pessary independently. Others prefer regular professional follow-up — both options are fine.

7. Do I need a doctor’s referral?
   You can book directly with one of our pelvic health physiotherapists in Barrie, no referral is needed. However, prior to fitting you for a Pelvic Pessary, you will need to be examined by your physician or gynecologist so they can confirm that you have no contraindications to pessary usage. Click here to download the form that your physician or gynecologist needs to complete.

Book Your Pessary Fitting
or Pelvic Health Assessment
at Resolution in Barrie today

If you’re experiencing pelvic pressure, prolapse, or bladder leakage, a pelvic pessary fitting may be a simple and effective solution.

Contact Resolution Physiotherapy in Barrie, Ontario today to schedule your pelvic health assessment and learn if a pessary is right for you.

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