Proper Placement for the Gelhorn Pessary Pelvic Floor Support

Gellhorn Pessary

• This pessary supports the prolapsed organ and also occupies space, so it is used in treatment of advanced stages of prolapse. If the woman has had a hysterectomy, the cervix rests behinds the pessary surface. According to Dr. Christina Lewicky-Gauppin, this "allows for some suction to form against the vagina as well. The stem prevents turning the support within the vagina and points towards the posterior vagina and introitus." She notes that the patient's vagina must be relatively large to accommodate the Gellhorn pessary.

Fitting the Gelhorn Pessary

• Before insertion, wash your hands thoroughly. Lubricate the pessary, and insert it edgewise and in a slightly slanted direction, avoiding the urethra. Push the perineum down during insertion. Insert the pessary into the vagina with a quick screwing motion. Once firmly in the vagina, push the pessary up until only the end of the stem appears in the entrance to the vagina. The pessary should lie under the cervix, propping up the pelvic floor.

Removal

• Unlike some other types of pessaries, the woman can remove the Gellhorn model herself, without the aid of a health care professional. Wash your hands, and remove the pessary by grasping the stem at the end of the vagina with the fingers, or use a clamp. Lewicky-Gauppin recommends a ring forceps who those who cannot remove the device manually. Break the pessary's suction by "inserting another finger in a sweeping motion around the base," according to Lewicky-Gauppin.

Size and Material

• The foldable Gellhorn pessary is available in nine sizes, ranging from 1.5 to 3.5 inches. All sizes have drainage holes in the pessary's base. The device is made of medical-grade silicon. The gynecologist will choose the correct size for you. A correctly fitted pessary does not hurt, so if you experience any discomfort or any bleeding, call your doctor immediately. It may take several fittings before the right size for your vaginal anatomy is found. The pessary may increase vaginal secretions, and that is normal.