Pessary: A Modern, Non-Surgical Bladder Support Option

When many women hear the word pessary, they picture something outdated or only used by their grandmother. But pessaries have come a long way. Today, they are modern, discreet, and can be a smart non-surgical tool for treating bladder leakage or prolapse.

As a urogynecologist, I love pessaries because they offer women control and flexibility with very little risk and no downtime. Whether you want a temporary solution, a bridge to surgery, or a long-term alternative, a pessary can fit into your life in a way that works for you.

What Is a Pessary?

A pessary is a small, medical device worn inside the vagina to help support the bladder, uterus, or vaginal walls. It can also help reduce or prevent bladder leaks (stress incontinence).

Pessaries have been around for centuries, historically made from everything from waxed cork to brass. Today’s pessaries are made of medical-grade silicone or other modern materials designed for comfort, safety, and long-term use.

Types of Pessaries
Pessaries fall into two main categories:

1. Pessaries for Prolapse

These are designed to help support the bladder, uterus, or vaginal walls that have shifted from their normal position.

• Ring Pessary (with or without support) – The most common type, easy to insert and remove.

• Dish Pessary – Similar to the ring but with more support for certain types of prolapse.

• Gelhorn, Cube, Donut Pessaries – Used for more advanced prolapse or when more support is needed.

• Custom Pessaries (Cosm Medical) – 3D printed for a perfect fit when standard sizes don’t work.

Currently, prolapse pessaries are typically fitted by a healthcare provider to ensure the correct size and comfort.

2. Pessaries for Stress Incontinence

These are designed to provide gentle support to the urethra and help reduce leaks with coughing, sneezing, exercise, or lifting.

• Traditional Silicone Pessaries (Fitted by Provider) – Available in ring or dish shapes with a small knob that supports the urethra.

• YoniFit – A reusable pessary shaped like a menstrual cup, available in multiple sizes through a provider. Learn more here
  

• Over-the-Counter Pessaries – Great options for women who want to manage leakage without a prescription or fitting:

  • Uresta – A reusable device available in five sizes, with a starter kit to help you find the best fit. Learn more here

  • Poise Impressa – A single-use device designed for stress incontinence, available in three sizes. Learn more here

  • Revive – A reusable option that can be worn up to 12 hours a day and replaced monthly. Learn more here
    

Who Is a Good Candidate for a Pessary?

Most women with prolapse or stress urinary incontinence should at least be offered a pessary as an option.

Good candidates:

• Women who want a non-surgical solution.

• Those waiting for surgery and need temporary support

• Postpartum women who want to support healing.

• Women who leak only during certain activities and want a “just when needed” solution.

Not ideal for:

• Women with pelvic pain, discomfort with tampons, or certain skin conditions.

• Women who have had pelvic radiation or untreated pelvic cancers.

Why I Think Pessaries Deserve a Rebrand

Pessaries are modern, discreet, and flexible. They can be worn daily, for special occasions, or even just during workouts or travel. They don’t mean you’re “old” or “frail.” They mean you’re actively managing your pelvic health in a smart, non-surgical way.

Where to Start

If you’re curious about a pessary:

• Ask your provider – Start with your primary care doctor or gynecologist.

• Explore over-the-counter options if you prefer a self-directed approach (links above).

• Remember: fit matters – A properly fitting pessary should feel comfortable, and you shouldn’t even notice it’s there.

The Bottom Line

A pessary isn’t for everyone, but for many women, it’s a simple, effective tool for reclaiming confidence and comfort, without surgery. Your bladder health is worth exploring all the options. And a pessary just might be one of the most underrated ones.

 Listen to this topic and more on the While You Wait… Podcast
Follow me on Instagram @womensbladderdoctor

Want to See Your Options?
Here are a few direct links to explore the devices I mentioned:

Posie Impressa https://www.poise.com/en-us/products/impressa
What is Yōni.Fit? – Yōni.Fit
Bladder Support for Women | Uresta
FemTherapeutics – Pessary for prolapse support
Personalized Pessaries for Pelvic Floor Disorders | Cosm Medical
Revive Reusable Bladder Support for Women – Leak Protection & Comfort