Procedures

If you are experiencing pelvic organ prolapse, your doctor may have suggested that you address it with a pessary, and a pessary fitting. Pelvic organ prolapse occurs when one or more of the organs in the pelvis slips down from its normal position and bulges out into the vagina. It may involve your uterus, bladder, bowel, or even the top of the vagina itself. Although it is not dangerous, it can be uncomfortable or painful.

If lifestyle changes, such as losing weight and avoiding heavy lifting, and pelvic floor exercises have not resolved your pelvic organ prolapse, your doctor may recommend that you try a pessary. These are prosthetic devices that can be inserted into your vagina to provide support to its internal structure.

In addition to pelvic organ prolapse, they are also used to help address urinary incontinence. They might also be used in some cases as a vessel to slowly administer certain medications. For many women, a pessary can help them avoid the need for pelvic surgery.

However, it is important to get the right fit for your pessary to be effective. Here is a look at how you can prepare for your pessary fitting and what to expect.

The Pessary Fitting Process

Before getting a pessary, your doctor will perform a vaginal exam to diagnose the severity of your prolapse and take careful measurements to ensure that you get the right fit for your condition. You may be asked to strain so your doctor can determine the full extent of the prolapse.

Your doctor will advise you on whether you need to empty your bladder prior to the fitting. In some cases, it may be desirable to have a slightly full bladder, particularly if the pessary is being fitted with the aim of alleviating urinary incontinence.

Pessary Types

There are two main categories of pessaries: space-filling and support pessaries. These are available in different sizes and shapes to accommodate body differences among women. They are typically made using medical-grade silicone, which allows them to resist absorption while remaining durable.

The ring pessary is the most common type of support pessary because of its ability to fit a wide range of women and its suitability for all stages of pelvic organ prolapse.

When it comes to space-filling pessaries, the Gellhorn is the most popular variety. Featuring a broad base with a stem in various lengths, it can fit most women comfortably.

Insertion

Your gynecologist will insert the pessary during the initial fitting, and he or she may need to try different sizes and styles to find the best one for you.

If a pessary is properly sized, you should not be able to feel it. If you are uncomfortable once it has been inserted, it is probably too large for you, and your doctor will likely try a smaller size. Your doctor will use lubricant on the leading edge of the pessary to make insertion more comfortable.

Pessary fitting may require a bit of trial and error among the different pessary types and sizes until the best solution is found.

You may be asked to visit your doctor again a few weeks later to assess the device’s fit. At this appointment, your gynecologist will remove your pessary to examine your vagina for any signs of irritation. If everything looks okay, they will then clean it and replace it. You will also be asked to return for follow-up appointments.

Caring For Your Pessary

Once your pessary has been fitted, your doctor will advise you on the best way to remove and clean the specific model chosen. Ring pessaries can be removed by you and may need to be cleaned weekly or nightly. The procedure generally entails cleaning with a mild soap and water before rinsing it thoroughly. It must be dried completely before being reinserted into the vagina. Water-based lubricant can help make the insertion process more comfortable.

Some types of pessaries can only be removed and cleaned by a doctor, such as a Gellhorn pessary. If you use this type of pessary, you will be asked to see your doctor every one to three months so that it can be removed, cleaned, and replaced.

Side Effects

Although pessaries are a safe and comfortable option for many women, it is important to be aware of the potential for mild side effects such as discharge, urinary tract infections, and vaginal irritation. The removable nature of pessaries means that side effects can usually be alleviated easily.

Although many women opt to remove their pessary before sexual activity, it is possible to have sexual intercourse with a ring pessary in place.

Get In Touch With The Women’s Healthcare Team

If you would like to learn more about pelvic organ prolapse treatments and pessary fittings, get in touch with the women’s healthcare professionals at Raleigh Gynecology & Wellness. Serving the Triangle Area for more than 30 years, our team provides a broad range of women’s healthcare services with a focus on patient comfort.

Pelvic organ prolapse occurs when the bladder, uterus, or rectum drops or bulges down into the vagina. It is not a life-threatening condition, but the discomfort it causes prompts many women to seek a solution. A vaginal pessary is often recommended because they are noninvasive and can be effective for many types of prolapse. These devices are placed into the vagina to support areas where pelvic organs are prolapsing.

Pessaries can also help women who experience stress incontinence, which is characterized by urine leaking when coughing, exercising, or straining. They may also be used temporarily for women who experience incontinence during pregnancy.

Types Of Vaginal Pessaries

Most pessaries are made of silicone, which is harmless and nonabsorbent in addition to being soft and comfortable. There are several types of pessaries that may be used. Your doctor will perform an exam to determine the severity of your prolapse and recommend the right type of pessary for you.

Here is an overview of the most popular types of pessaries.

Ring

The most common type of pessary is a ring-shaped device that can be easily inserted and removed without the help of a doctor. This is often the first type of pessary a doctor will recommend.

Gehrung

The Gehrung is a u-shaped vaginal pessary that is appropriate for women who are experiencing more advanced uterine prolapse as it can be molded to fit the user.

Gellhorn

A Gellhorn pessary is a disc-shaped device that features a small knob in the middle and can address more severe prolapse.

Cube

For women who are experiencing advanced stage prolapse, a cube pessary can be compacted down and inserted into the vagina, where suction is used to support areas that are affected by prolapse.

Who Needs A Vaginal Pessary?

Pessaries are a nonsurgical method to treat pelvic organ prolapse. In many cases, a pessary is enough to keep mild pelvic organ prolapse under control.A pessary may also be used for women with more serious pelvic organ prolapse for whom a surgical procedure to correct the condition would be dangerous for medical reasons.

Pessaries may also be used for certain young women who experience uterine prolapse during pregnancy. They can hold the uterus in place before it enlarges and becomes trapped in the vaginal canal.

It is important to keep in mind, however, that pessaries will not cure pelvic organ prolapse. Instead, they can help to slow its progression and manage the symptoms by providing support to the vagina. For many women, their symptoms will greatly improve with pessary use, while others report their symptoms go away entirely.

Are There Any Potential Risks?

Many women opt for a pessary rather than surgery because of its noninvasive nature. However, it is important to understand that there are a few potential complications. For example, it may cause the vaginal wall to wear away, potentially causing an opening to form between the vagina and the rectum, although this is very rare. Other potential issues include bleeding and open sores.

These complications can be minimized by ensuring that the pessary is correctly fitted and is not placing too much pressure on the vaginal walls. Postmenopausal women may be given an estrogen cream or tablets to help with any irritation caused by the pessary. Regular cleaning is another way to reduce the risk of complications. Women should follow the schedule and method recommended by their doctor.

Pelvic organ prolapse can present in many different forms, and your doctor will fit your pessary to ensure that it holds pelvic organs in an appropriate position without causing you any discomfort. Different sizes are available, and your doctor will be able to determine which one is the right fit. It may take some trial and error to find one that feels right.

Your doctor will also teach you how to take the pessary out, clean it, and reinsert it and instruct you on how often this needs to be done. If you have trouble carrying out this process on your own, you may be able to set up regular appointments to have your doctor take care of it for you.

In some cases, it is possible to leave the pessary in place during sexual intercourse. This will depend on the type of pessary you have and your comfort level; your doctor can advise you on whether this is appropriate in your case. However, it is important to keep in mind that you will be unable to insert a diaphragm while you are wearing a pessary. If this is your preferred method of birth control, it is important to talk to your doctor.

Reach Out Ti The North Carolina Women’s Healthcare Specialists

To find out more about your pelvic organ prolapse treatment options and how pessaries can benefit you, make an appointment with the North Carolina gynecology specialists at Raleigh Gynecology and Wellness today.

If your doctor has recently told you that you need a colposcopy, you may be experiencing a variety of emotions. You’re probably wondering what to expect from the procedure itself, but your top concern is likely the reason your doctor wants you to undergo the procedure in the first place. Here is a closer look at why you might need a colposcopy.

What Is A Colposcopy?

A colposcopy is a common gynecological procedure in which your doctor will examine your cervix, vagina, and vulva to look for signs of disease. While a Pap test gathers a sample of cells from your cervix so they can be tested for the early changes that may lead to cervical cancer, a colposcopy is used to confirm and diagnose any potential problems that the Pap test discovers. If your Pap test results indicate abnormal cells or you test positive for human papilloma virus (HPV), a colposcopy can be used to gather more information about these cellular changes and determine if any additional treatments are needed.

What Happens During A Colposcopy?

This procedure is normally carried out in your doctor’s office. You will be asked to lie down on the exam table and place your heels in stirrups attached to the table. Your doctor will then use a tool known as a speculum to open up your vagina so they can obtain a clear view of your cervix.

Next, your doctor will lightly wipe the areas to be studied using a vinegar or iodine solution that will help them see abnormal areas more clearly.

If any areas look unhealthy, your doctor will perform a biopsy on them. This means they will remove a small amount of tissue for a pathologist to examine. The pathologist will look at the tissue sample under a microscope to identify any abnormal cells. Although the colposcopy might suggest you could have precancerous tissue or cancer, a biopsy is needed to confirm the diagnosis. If the area of abnormal cells is small, it may be possible for your doctor to remove all of it during your biopsy. The results of the biopsy will determine if any additional treatments are needed.

In addition to checking the cells, the test is also used to look for signs of genital warts, inflammation, noncancerous growths known as polyps, and the type of abnormal changes that may lead to cancer.

Why Do Doctors Recommend A Colposcopy?

The most common reason that a doctor recommends a woman undergo a colposcopy is because a pap smear has detected potentially abnormal cells. In other cases it is done because certain strains of human papilloma virus (HPV) are detected.

These findings may indicate the presence of precancerous cells on the cervix. However, it is important to keep in mind that not all abnormal cells will lead to cervical cancer. Some irregularities that are detected in the early stages can go away without treatment and are not cause for concern. More significantly abnormal cells can be removed or treated so that they won’t have a chance to progress to cancer.

How Can You Prepare For Your Procedure?

It is best to avoid scheduling a colposcopy for the week of your period. You should also let your doctor know if you are pregnant or could be pregnant before your appointment. Your doctor might recommend that you take an over-the-counter pain medication prior to the procedure in case a biopsy is needed to help you avoid discomfort, although the procedure itself is typically well tolerated.

Many doctors recommend that women stop using any type of vaginal medication or cream or inserting anything into the vagina – such as by using tampons or having sexual intercourse – in the 24 to 48 hours before a colposcopy. Your doctor will give you specific instructions when you make your appointment.

Be aware that you may experience some spotting or a dark vaginal discharge after the procedure, along with some cramping, soreness, or light bleeding. Be sure to have sanitary pads on hand. Follow your doctor’s instructions on how long you should wait before having sex or using any type of products that go inside the vagina. Your recovery time will be shorter if you do not get a biopsy during your colposcopy.

Get In Touch With Raleigh Gynecology & Wellness

Get in touch with Raleigh Gynecology & Wellness for all your women’s health needs. Our professional and understanding team can explain any procedures that you might need and address all of your health concerns.

If you have recently undergone a colposcopy or your doctor has recommended that you get one, learning more about what to expect can help alleviate your anxiety. Here is a closer look at what you can expect during recovery.

What To Expect After A Colposcopy

After your colposcopy, do not be surprised if you notice soreness in your vagina for a couple of days. If your colposcopy included a biopsy, you might also notice some dark-colored discharge or spotting. It is best to use pads or pantyliners to address this instead of tampons.

You can return to work right away, but it is best to avoid exercising for at least a day after your test. If your job is particularly strenuous, you may be advised to take the day off.

If you are experiencing pain, you can take over-the-counter pain medications such as acetaminophen, naproxen, or ibuprofen, but make sure you follow proper dosing instructions. If you take aspirin or blood thinners, check with your doctor to find out when it is okay to start taking them again. If your doctor has prescribed any new medications, make sure you understand how and when you are supposed to take them.

When Can I Resume Normal Activities?

After a colposcopy, you can shower as soon as you feel like it. If you did not have a biopsy, it is okay to have sexual intercourse whenever you are ready. However, if you did have a biopsy, it is best to wait at least a week before having sex, douching, or using tampons to give your cervix time to heal.

It is also important to continue taking any medications that you normally take as usual, and this includes birth control.

Are There Any Side Effects I Should Look Out For?

A colposcopy, whether it includes a biopsy or not, is a routine procedure and serious effects are uncommon. One of the biggest dangers to look out for is bleeding or an infection that requires treatment.

You should contact a healthcare professional if you experience bleeding that is heavier than expected. If you are soaking through pads every hour for two or more hours, it is important to seek medical attention. However, if you suspect it could be your period and the timing is right, you do not need to be overly concerned. You should also get medical help if you experience chills, fever, severe pain in your lower abdomen, or discharge that is heavy, yellow, or has a foul odor.

If you are pregnant, it is relatively safe to get a colposcopy, but keep in mind that pregnant women often experience more bleeding following a biopsy than those who are not pregnant due to the greater blood supply in the cervix during pregnancy.

What Happens If My Results Are Abnormal?

It could take one to two weeks to get your test results. Many times, colposcopy results will indicate that everything is normal. However, if your results show the presence of abnormal cells, your doctor will tell you what to do next.

In certain cases, your doctor might recommend waiting to see if your cells heal on their own. In that case, you will undergo another Pap test in the near future to keep an eye on the cells. Getting ongoing follow-up after a colposcopy is important to make sure your cervix is healthy.

If you do need further treatment, there are several procedures that your doctor might recommend. All of these procedures can be very effective, but your doctor will advise you to continue getting regular exams in case the abnormal cells return. Here’s a look at the procedures you might undergo.

Laser

A laser procedure can be used to remove abnormal cells from your cervix so that normal cells can grow back in their place.

LEEP

The Loop Electrosurgical Excision Procedure, or LEEP, uses a thin wire loop that contains an electrical current to remove abnormal cells.

Cone Biopsy

In a cone biopsy, a cone-shaped wedge will be cut out of your cervix to remove abnormal cells.

Cryotherapy

In this procedure, the abnormal cells will be frozen off and destroyed.

Your doctor will explain to you which procedure you need and how you can prepare for it. Be sure to ask questions if you don’t understand the recommendations and instructions.

Reach Out To Raleigh Gynecology And Wellness

A colposcopy may be a routine procedure, but it’s normal to have some anxiety about the procedure itself and what your results may mean. At Raleigh Gynecology & Wellness, our experienced healthcare team can explain any procedures that you need and address your concerns.

A colposcopy is a fairly common medical procedure that a doctor may recommend to detect signs of disease in your cervix, vagina or vulva, particularly if a Pap smear indicates abnormal results. If your doctor has ordered this procedure, you may have a lot of questions. In addition to concerns about your health, you might also be wondering how it might impact your plans to get pregnant.

Here is a closer look at what the procedure entails and how it may affect your family planning timeline.

What Is A Colposcopy?

A colposcopy is a procedure during which your doctor obtains a closer look at your cervix, vagina, and vulva. It is usually carried out in your gynecologist’s office. You will be asked to lie down and place your feet in stirrups. The doctor will then insert a speculum to hold your vagina open, just as they would to carry out a Pap smear.

However, in a colposcopy, a tool called a colposcope is used to get a clearer view. This magnifying tool will not be inserted into your body. Instead, it is used alongside a bright light outside the body to see inside. Your doctor may identify areas where tissue samples need to be taken to determine the cause of abnormalities. The procedure takes about 20 minutes.

How Soon Can You Get Pregnant After The Procedure?

Many women wonder how long they need to wait before getting pregnant after having a colposcopy. There is not a simple answer to this question. Here is a look at the factors that may influence your pregnancy timeline.

The Suspected Medical Issue

First, you need to keep in mind that an abnormal Pap smear result does not always point to cancer. It simply means that some cells in your cervix have changed. Second, many times, these issues will go away on their own or can be treated easily and your doctor just needs to keep an eye on it via regular screening.

Women who have low-grade abnormalities and are up to date on Pap tests can typically go ahead and try to conceive.

However, if your doctor finds high-grade abnormalities, you may need further treatment. This does not necessarily mean that you have cancer or will get it, but if a type of loop excision, laser ablation, or cone biopsy is needed, you may need to wait a few months to try to get pregnant as some of these treatments could complicate a pregnancy. Your doctor will provide specific instructions.

Even if you do need one of these procedures, keep in mind that most women will go on to have a safe pregnancy and healthy baby afterward. Be sure to discuss your plans with your doctor to get advice tailored to your specific medical situation.

Biopsies

Not all women will need a biopsy during their colposcopy. If your doctor did not need to take any samples during the procedure, you will most likely not have any restrictions in terms of sexual activity after your exam, although you may experience light bleeding or spotting afterward.

However, if your doctor did need to take a biopsy during the procedure, you should avoid placing anything inside your vagina and having sexual intercourse for at least a week after the procedure. Your doctor may instruct you to wait longer, so be sure to follow the specific instructions you are given.

If you get a cone biopsy, which is a procedure in which your doctor removes a small cone-shaped part of your cervix, there are some additional precautions as it takes longer for the cervix to heal. You may be advised to wait four to six weeks after your procedure or until your doctor tells you your cervix has fully healed before having sexual intercourse. You may also be instructed to avoid strenuous exercise, lifting heavy objects, doing heavy housework, swimming, taking baths, or using tampons or douches during this time.

After a cone biopsy, you may experience vaginal discharge that looks like menstrual bleeding for a few weeks. Your period may also be later or heavier than usual, so you may wish to wait until your cycle returns to normal before trying to conceive.

Get In Touch With Raleigh Gynecology And Wellness

Reach out today to Raleigh Gynecology and Wellness to make an appointment to discuss your health concerns. Our team of highly trained physicians can help women of all ages manage a broad range of conditions and disorders. Compassionate and specialized care are core values of our practice and our friendly doctors will be happy to discuss how any abnormal Pap results and subsequent follow-up procedures could impact your family planning timeline.