IS case 516: Pessaries
Imaging Sciences URMC 2010
Publication Date: 2010-09-10
History
Patient is a 79-year-old female with hip pain.
Findings
Incidental note of a pessary.
Diagnosis
Pessaries
Discussion
Pessaries are commonly used to treat genital prolapse. They are indicated in women not suitable for surgery, those who have declined surgery, those who may want to have children in the future, or in neonates or children. There are two main types of pessaries: support pessaries, which elevate the vagina; and space occupying pessaries, which rely on impingement of surrounding structures. Some pessaries have to be removed nightly and others can be left in for months at a time. Pessaries are usually well tolerated but adverse effects including discharge, pain, and bleeding may occur. Rarely, a pessary may become impacted or erode into surrounding structures.
Pessaries come in a variety of shapes and sizes but are commonly in the form of a flat ring. Pessaries are generally radiopaque as they are usually made from silicone or heavy latex rubber. A radiologist should be aware of this device as it should not be mistaken for a foreign body. Also, the radiologist can aid in the diagnosis or localization in pessary impaction/erosion.
References
- Hanavadi S, Durham-Hall A, Oke T, Aston N. Forgotten vaginal pessary eroding into rectum. Ann R Coll Surg Engl. 2004 Nov;86(6):W18-9. PMID: 16749957
- Thakar R, Stanton S. Management of genital prolapse. BMJ. 2002 May 25;324(7348):1258-62. PMID: 12028982
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