pessary /pes″ərē/ [Gk, pessos, oval stone] , a device inserted in the vagina to treat uterine prolapse, uterine retroversion, or cervical incompetence. It is used in the treatment of women whose advanced age or poor general condition precludes surgical repair. Pessaries are also used in younger women in evaluating symptomatic uterine retroversion and in managing cervical incompetence in pregnancy. A pessary must be removed, usually daily, for cleaning. A Smith-Hodge pessary is a rubber- or vinyl-covered wire rectangle that fits between the pubic bone and the posterior vaginal fornix, supporting the uterus and holding the cervix in a posterior position. A Gellhorn pessary is an inflexible device made of acrylic resin or plastic (Lucite) in the form of a large collar button. It has a canal through the stem that allows drainage of vaginal secretions. The large end of the pessary is placed deep in the vagina, the small end of the stem protruding at the introitus. A doughnut pessary is a permanently inflated flexible rubber doughnut that is inserted to support the uterus by blocking the canal of the vagina. An inflatable pessary is a collapsible rubber doughnut to which a flexible stem containing a rubber valve is attached. The collapsed pessary is inserted, inflated with a bulb similar to that of a sphygmomanometer, and deflated for removal. A bee cell pessary is a soft rubber cube. In each face of the cube is a conical depression that acts as a suction cup when the pessary is in the vagina. A diaphragm pessary is a contraceptive diaphragm used for uterovaginal support. A similar device of somewhat heavier construction is sometimes used. A stem pessary is a slim curved rod that can be fitted into the cervical canal for uterine positioning. It is rarely used today.
