Something New at Nicole Meyer Physical Therapy and Wellness: Pessary Fitting is Here
I’m super excited to report a new offering at the practice to better support women with urinary incontinence and pelvic organ prolapse, pessaries!
Why I Added Pessary Fitting to My Practice
I completed a pessary fitting course because I kept seeing the same thing over and over in my practice — women managing prolapse or stress urinary incontinence who had been told their only real options were surgery or doing their Kegels and hoping for the best. And for many of them, neither felt right.
A pessary is a small, removable silicone device that's inserted into the vagina to provide support for prolapsed pelvic organs or to help reduce leakage. It's not a new invention, pessaries have been around for decades, but access to proper fitting has often been limited to gynecologists or urogynecologists, with long wait times and not a lot of hands-on education for patients.
I wanted to be able to offer my patients something more. A conservative, non-surgical option that actually fits into their real life.
What Is a Pessary, Exactly?
A pessary sits inside the vagina and works by mechanically supporting the pelvic floor and pelvic organs. Depending on the type and fit, it can:
Reduce the sensation of heaviness, pressure, or bulging from pelvic organ prolapse
Decrease or eliminate urine leakage with exertion (stress urinary incontinence)
Allow women to stay active during running, lifting and exercising with more confidence and comfort
There are many different shapes and sizes of pessaries, which is exactly why fitting matters. A well-fitted pessary should be comfortable enough that you barely notice it's there.
Who Might Benefit?
Pessaries can be a great option for women who:
Have been diagnosed with pelvic organ prolapse (cystocele, rectocele, uterine prolapse, etc.)
Experience urine leakage with exercise, sneezing, coughing, or laughing
Want to try a non-surgical approach before considering other interventions
Are waiting for surgery and need relief in the meantime
Have had surgery but still have symptoms
Are postpartum and dealing with pelvic floor changes
Simply aren't ready for surgery — or don't want it at all
There's no single right answer for every woman, and that's okay. A pessary might be exactly what you need, or it might be one part of a bigger picture that also includes pelvic floor PT, lifestyle changes, or other support.
What to Expect When You Come In
I want you to feel informed, not overwhelmed. Here's how a pessary fitting appointment works:
We'll start by discussing about your symptoms, your goals, previous treatment and what the demands of your life really look like. Then we'll do an internal assessment to understand your anatomy and pelvic floor function, which also helps guide which type of pessary will fit you best.
From there, we'll try a pessary and check the fit. You'll have time to walk around, check comfort, and ask questions. We'll also go over how to manage the pessary, insertion, removal, cleaning , so you feel confident taking care of it at home.
Follow-up is part of the process too. Getting the fit right sometimes takes a visit or two, and that's completely normal.
The Perfect Fit?
I'm not going to tell you a pessary is magic, reverses all your symptoms or that it works for everyone. Some women love it and never look back. Others find it's not quite the right fit for their lifestyle or anatomy.
What I can tell you is that it's worth knowing your options. Too many women suffer in silence, avoiding the trampoline with their kids, planning their day around bathroom access, eliminating rigorous exercise from their lives or just quietly accepting discomfort because they don't realize there are real, practical things that can help.
You deserve real information and real support. That's what I'm here for.