Pelvic organ prolapse can leave you feeling heavy, uncomfortable or less confident in your body, but you do not have to simply put up with it. There are several ways to manage prolapse, and surgery is not always the first or only option.
At Northside Therapies in Kallangur, pelvic health care begins by looking at you as a whole person. Pelvic floor muscle training, breathing and managing pressure through the abdomen and pelvis form the foundation of conservative prolapse management. When additional support is needed, a vaginal pessary may be considered as part of an individual treatment plan.
Dr Simone Keddy, an experienced pelvic health osteopath and practice principal at Northside Therapies, is trained to assess pelvic organ prolapse and fit vaginal pessaries. The aim is not simply to fit a device. It is to understand the factors contributing to your symptoms and help you find an approach that supports your comfort, function and everyday life.
What is pelvic organ prolapse?
Pelvic organ prolapse, often shortened to POP, occurs when one or more pelvic organs, such as the bladder, uterus, bowel or top of the vagina move down from their usual position and bulge into the vagina.
Some people have a prolapse without noticeable symptoms. Others may experience:
- heaviness, pressure or a dragging sensation in the pelvis
- a lump or bulge in or around the vagina
- difficulty emptying the bladder or bowel
- urinary leakage or urgency
- discomfort with exercise, lifting or prolonged standing
- changes in sexual comfort or confidence
Prolapse symptoms can affect daily life, but there are options. A thorough assessment can help identify which factors are most relevant to you and where to begin.
Pelvic organ prolapse management: build the foundations
At Northside Therapies, a pessary is viewed as an additional support, not a replacement for understanding how your whole body is functioning. The first line of conservative prolapse management commonly includes pelvic floor muscle training, learning to manage intra-abdominal pressure and improving breathing coordination. Bowel habits, toileting technique and the way you lift, move and exercise may also influence how much pressure reaches the pelvic floor and how noticeable your symptoms feel.
Your individual plan may include:
- Pelvic floor muscle training: This is not always about squeezing harder. Assessment may consider muscle strength, tone, endurance, coordination and your ability to fully relax.
- Breathing and pressure management: Coordinating breathing with effort may help you manage pressure during lifting, exercise, coughing and everyday movement.
- Bladder, bowel and toileting habits: Addressing constipation and avoiding repeated straining can reduce unnecessary load on the pelvic floor.
- Body mechanics: Posture, lifting strategies and movement through the spine, pelvis and hips may be considered in relation to your symptoms.
- Whole-body movement: Where relevant, the assessment may also explore leg and foot mechanics and how forces move through the body during standing, walking and exercise.
- Lifestyle and activity demands: Your work, exercise, caring responsibilities and personal goals all matter when developing a realistic plan.
There is no single “perfect” posture, breathing pattern or way to move, and these factors do not necessarily cause prolapse. The purpose of a whole-person assessment is to understand what may be influencing your symptoms and tailor your management accordingly.
What is a vaginal pessary?
A vaginal pessary is a removable device placed inside the vagina to support prolapsed organs and vaginal walls. Pessaries come in different shapes and sizes and are commonly made from medical-grade silicone or other medical materials.
The ring pessary is one of the most commonly used types. Other designs include Gellhorn and cube pessaries. The most appropriate option depends on your anatomy, type of prolapse, symptoms, activity, sexual preferences and ability or desire to manage the pessary yourself.
A pessary does not cure prolapse or strengthen the pelvic floor. Instead, it provides internal mechanical support that may reduce symptoms such as bulging, heaviness and discomfort. It can be used for short-term or longer-term management and can work alongside pelvic floor rehabilitation and pressure-management strategies.
When might a pessary be helpful?
A pessary may be worth considering when first-line strategies are not providing enough symptom relief or when additional support would help you participate more comfortably in daily activities.
You may consider a pessary if you:
- want a non-surgical option for prolapse symptoms
- would like extra support during work, exercise or other activities
- want to delay surgery or are waiting for surgery
- prefer to avoid surgery
- are not currently a suitable candidate for an operation
- want to preserve future pregnancy options
Choosing a pessary does not close the door on other treatments. Your options can be reviewed as your symptoms, circumstances and goals change.
Pessary assessment and fitting in Kallangur with Dr Simone Keddy
Dr Simone Keddy provides pelvic organ prolapse assessment and pessary fitting at Northside Therapies in Kallangur. Simone is a co-founder of the Osteopathic Pelvic Health Institute of Australia and has extensive experience in pregnancy, postpartum and pelvic health care.
Your assessment may include a detailed health history, discussion of your symptoms and goals, and an external physical examination. An internal vaginal examination is required to assess prolapse and pelvic floor function and to determine a suitable pessary type and size. This is only undertaken with your informed consent, and you remain in control throughout the appointment.
A well-fitted pessary should be comfortable, remain in place and allow you to empty your bladder and bowel. You should generally be able to move through normal daily activities without being constantly aware of it.
Finding the right fit can take more than one attempt. If the first pessary feels uncomfortable or falls out, it does not necessarily mean a pessary will not work for you. A different size or style may be more suitable.
A pessary works best as part of an individual plan
Fitting the pessary is only one part of care. The osteopathic approach at Northside Therapies continues to consider the whole person and the physical and lifestyle factors that may affect symptoms or reduce how well the pessary supports you in everyday life.
For example, ongoing constipation and straining, poorly coordinated breathing during effort, chronic coughing or difficulty managing pressure during lifting may continue to load the pelvic floor. Pelvic floor muscles that are weak, overactive or poorly coordinated may also need targeted care. Addressing relevant factors alongside pessary use gives the pessary the best opportunity to provide effective support.
Your plan may therefore combine pessary use with pelvic floor muscle training, breathing retraining, bowel and toileting advice, exercise modification, movement strategies and hands-on osteopathic pelvic health care where appropriate.
Cleaning, follow-up and everyday life
How a pessary is managed depends on its type, your comfort and the plan agreed with your practitioner. Some people learn to remove, clean and reinsert their pessary at home. Others prefer or need this to be done at follow-up appointments. Certain pessaries can stay in place for longer intervals, while others need to be removed more frequently.
Most people can continue normal daily activities with a correctly fitted pessary. Exercise and penetrative vaginal sex may depend on the pessary type and your individual symptoms. If sexual activity or a particular form of exercise is important to you, mention this during your assessment so it can be considered when selecting a pessary.
Follow the cleaning and review schedule provided for your specific device rather than relying on general instructions online.
Pelvic organ prolapse management: build the foundations
Pessaries are generally considered safe when correctly fitted, cared for and reviewed. Possible problems include:
- increased vaginal discharge
- spotting or bleeding
- irritation, pressure or discomfort
- vaginal sores or erosion
- difficulty passing urine or opening the bowels
- the pessary slipping or falling out
Contact your healthcare practitioner if you experience pain, persistent or heavy bleeding, offensive-smelling discharge, difficulty emptying your bladder or bowel, or a pessary that repeatedly falls out. Seek urgent medical care if you cannot pass urine or feel acutely unwell.
Regular reviews remain important even when the pessary feels comfortable. They allow the fit and condition of the pessary to be checked and the vaginal tissues to be examined.
Northside Therapies is located at 1592 Anzac Avenue in Kallangur, making pelvic health osteopathy and pessary fitting accessible to people from North Lakes, Mango Hill, Griffin, Narangba and Petrie, as well as surrounding North Brisbane and Moreton Bay communities.
You do not need to decide in advance whether a pessary is right for you. The first step is understanding your symptoms, your body and your goals. From there, Simone can discuss first-line management and whether the additional support of a pessary may be appropriate.
If you would like to discuss your symptoms and options, you can book a pelvic health appointment at Northside Therapies.
Book an appointment today
At Northside Therapies, we are passionate about providing gentle and effective osteopathic care. We believe in a whole-person approach, and work in partnership with you to ensure the best care for you. If you have any questions or would like to book an appointment, please don’t hesitate to get in touch. We are located in Kallangur, on the Northside of Brisbane. We look forward to helping your family thrive.
Contact Information
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FAQs
Most people can continue normal daily activities with a correctly fitted pessary. Whether a particular form of exercise is comfortable may depend on the pessary type and your individual symptoms, so it is worth discussing your usual activities during the fitting process.
Yes. A pessary provides mechanical support rather than strengthening the pelvic floor, so it may be used alongside pelvic floor muscle training, breathing and pressure-management strategies as part of an individual plan.
The first pessary is not always the right fit. A different size or style may be more suitable. Contact your healthcare practitioner if the pessary repeatedly falls out, causes pain or feels persistently uncomfortable.