Types of Vaginal Pessaries: A Complete Guide to Choosing the Right One

If you or someone you care for has been advised to use a vaginal pessary, you may quickly discover that there is more than one type. In fact, there are over a dozen designs, each suited to different conditions, body types, and lifestyles. Understanding the types of vaginal pessaries available can help you have a more informed conversation with your healthcare provider — and feel confident about the device you choose.

What Is a Vaginal Pessary?

A vaginal pessary is a small, removable device made from medical-grade silicone that is inserted into the vagina to provide internal support for pelvic organs. Pessaries are commonly prescribed for pelvic organ prolapse (POP) — a condition where the bladder, uterus, or rectum drops down into or through the vaginal opening — and for stress urinary incontinence.

Pessaries offer a non-surgical alternative to repair operations. They are safe for long-term use, can be self-managed at home, and in many cases allow for normal sexual activity. Studies show that pessary therapy resolves prolapse symptoms in up to 90% of patients.

The Main Types of Vaginal Pessaries

1. Ring Pessary

The ring pessary is the most widely used type and is usually the first choice clinicians try. It is a flexible silicone ring that folds in half for easy insertion, then springs open to sit behind the pubic bone and support the vaginal walls. Ring pessaries come with or without a membrane (support disk).

• Best for: Mild to moderate prolapse (Stage I–III), first-time pessary users, women who want to self-manage at home
• Can you have sex with it in? Yes — the ring pessary does not fill the vaginal space
• Cleaning: Can be left in for up to 3 months between clinic cleans, or removed and washed at home

The ring pessary fits approximately 70% of women who try one. View our medical-grade silicone ring pessaries here.

2. Gellhorn Pessary

The Gellhorn pessary has a disk-shaped body with a stem that sits against the vaginal floor, providing firm support. It is the most commonly used space-filling pessary and is considered the gold standard for advanced prolapse.

• Best for: Stage III–IV prolapse, wide genital hiatus, post-hysterectomy prolapse, rectocele
• Can you have sex with it in? No — it fills the vagina; must be removed beforehand
• Cleaning: Requires clinic removal and cleaning every 3 months, or self-removal if dexterity allows

3. Donut Pessary

As the name suggests, the donut pessary is a thick, toroidal (doughnut-shaped) device. It is firm, fills more of the vaginal space than a ring, and is used when ring pessaries are insufficient.

• Best for: Moderate cystocele, rectocele, or second/third-degree uterine prolapse where ring pessary has failed
• Note: More difficult to insert and remove than the ring — often managed at clinic visits

4. Cube Pessary

The cube pessary is a six-sided silicone device with concave faces that create gentle suction against the vaginal walls. It is particularly effective for advanced prolapse where other types have not worked.

• Best for: Advanced (Stage IV) prolapse, especially after hysterectomy
• Important: Must be removed and cleaned every night — it cannot be left in place for extended periods

5. Dish Pessary (Shaatz)

The dish or Shaatz pessary is a flatter, disk-shaped device. It is easier to insert than the Gellhorn but provides similar support. It suits women with a narrow vaginal opening who need a space-filling pessary.

6. Incontinence Ring / Incontinence Dish

These are variations of the ring and dish pessaries that include a small knob positioned under the urethra. The knob provides support at the urethral junction, making them specifically suited to stress urinary incontinence alongside mild prolapse.

How Do Doctors Choose the Right Pessary Type?

Pessary fitting is not one-size-fits-all. Your clinician will take into account several factors before recommending a type and size:

• Stage of prolapse — mild prolapse responds well to a ring; advanced prolapse may require a Gellhorn or cube
• Type of prolapse — cystocele, rectocele, uterine, or vault prolapse each have preferred pessary types
• Sexual activity — women who want to remain sexually active are usually fitted with a ring
• Self-management ability — ring pessaries are the easiest to self-manage; cube pessaries require daily self-care
• Uterus present or absent — post-hysterectomy vault prolapse often needs a Gellhorn

On average, two to three pessary sizes are tried before the best fit is confirmed. A well-fitted pessary should sit comfortably in place, allow you to pass urine freely, and not be felt during normal activity.

Frequently Asked Questions

How long does a pessary last?

Medical-grade silicone pessaries are durable and typically last several years with proper care. They should be inspected at each clinic visit for signs of wear or discolouration.

Can you sleep with a pessary in?

Most pessary types — including ring and Gellhorn — can be worn overnight. The cube pessary is the exception and must be removed nightly.

Does wearing a pessary hurt?

A correctly fitted pessary should not cause pain. If you experience persistent discomfort, pressure, or any unusual bleeding, contact your healthcare provider — the size or type may need adjusting.

Where to Buy a Vaginal Pessary

Pessaries are medical devices and should be fitted by a qualified healthcare professional. Once fitted and sized, replacement pessaries of the same type and size can be purchased from specialist medical suppliers.

At SciMed Store, we supply medical-grade silicone ring pessaries in a range of sizes for patients and clinicians. All our pessaries are sterile, latex-free, and manufactured to rigorous medical standards.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before using a vaginal pessary.