What is a Pessary?

• According to British Pharmacopoeia (BP) – Pessaries are solid, single-dose preparations. They have various shapes, usually ovoid, with a volume and consistency suitable for insertion into the vagina. They contain one or more active substances dispersed or dissolved in a suitable bases that may be soluble or dispersible in water or may melt at body temperature. Excipients such as diluents, adsorbents, surface-active agents, lubricants, antimicrobial preservatives and colouring matter, authorized by the competent authority, may be added, if necessary.

• “PESSARY” is used in two different ways; the meaning is usually clear in the context. In the first sense, a pessary is a supportive device which is inserted into the vagina to treat a variety of medical conditions.

• A pessary can also be a pharmaceutical preparation which is used to deliver drugs rapidly through the mucus membranes of vagina.

• A small plastic appliance of varied form, introduced into the vagina which fits to support the uterus (womb), vagina, bladder to correct any displacement. Conventionally, pessary was used to support uterus, vagina and bladder. It is similar to outer ring of diaphragm. It can be placed temporarily or permanently. Most of the pessaries can be worn during intercourse.

• Uses:
  • Prolapsed uterus (means that the uterus droops or sags into the vaginal canal because the muscles and ligaments that should support it are weak. This may occur after multiple vaginal births or after pelvic surgery.
  • Urinary incontinence.
  • Retroverted uterus.
  • Cystocele (when the bladder droops down into the vagina).
  • Rectocele (when the wall of the rectum bulges into the bottom of the vagina).

• A pharmaceutical pessary is made by blending drugs with a substance which dissolves at body temperature. The drugs will slowly leach through the porous membrane of the vagina. Some medications must be specifically delivered vaginally to be most effective.

By Dr. Vibha Kamath
Read more on advantages of pessaries.
Read more on intra-vaginal drug delivery system.