Vaginal Pessary Clinic Sheffield
Professor Swati Jha
At a glance: Vaginal Pessary Clinic Sheffield
I offer a specialist vaginal pessary clinic in Sheffield for women seeking non-surgical treatment for vaginal prolapse. A pessary is a soft silicone device inserted into the vagina to support the pelvic organs and relieve symptoms including vaginal bulge, pelvic heaviness, and bladder problems.
As a consultant urogynaecologist with RCOG subspecialty accreditation, I assess, fit, and manage all pessary types — ring, cube, Gellhorn, and shelf pessaries — and provide long-term follow-up to ensure comfort and effectiveness. Most women achieve excellent symptom control without surgery, and I discuss both options clearly so you can make an informed choice.
I also advise on self-management and vaginal oestrogen for postmenopausal women, both of which significantly improve long-term pessary success.
I see patients privately at Spire Claremont Hospital and Circle Thornbury Hospital, Sheffield. A GP referral is not required.
Many women assume that prolapse means surgery. It often does not.
At my vaginal pessary clinic in Sheffield, I see women of all ages seeking an effective, non-surgical alternative to prolapse surgery. A vaginal pessary is frequently the first treatment I recommend. It works quickly, requires no anaesthetic, and for many women provides excellent symptom control for years — sometimes indefinitely.
A well-fitted pessary can:
- Reduce or eliminate the feeling of vaginal bulge
- Relieve pelvic pressure and heaviness
- Improve bladder emptying and reduce leakage
- Allow you to remain active, exercise and travel
- Delay or avoid surgery entirely
- Support prolapse comfortably while awaiting an operation
What to Expect at a Pessary Clinic
- ✓ Consultant-led assessment — I personally see every patient
- ✓ Pelvic examination to confirm prolapse type and severity
- ✓ Pessary selected and fitted in the same appointment
- ✓ Self-management teaching if suitable
- ✓ Structured follow-up and long-term pessary management
Appointments take 30–45 minutes. No GP referral required.
What Is a Vaginal Pessary?
A vaginal pessary is a soft, flexible silicone device inserted into the vagina to provide mechanical support to prolapsed pelvic organs. It acts as an internal support structure — holding the bladder, uterus, or bowel in a more anatomically correct position and reducing the symptoms they cause.
Pessaries do not repair prolapse, but they can effectively control symptoms in the majority of women. Clinical evidence suggests that around 70–80% of women achieve satisfactory symptom control at 12 months with a well-fitted pessary.
Pessaries are suitable for prolapse affecting any compartment, including:
- Cystocele — bladder descent into the front vaginal wall
- Uterine prolapse — descent of the uterus into the vaginal canal
- Vaginal vault prolapse — vault descent after hysterectomy
- Rectocele — bowel descent into the back vaginal wall
- Multi-compartment prolapse — involvement of more than one compartment
Key Facts About Pessary Treatment
- →Fitted in clinic — no anaesthetic or hospital admission
- →Immediately reversible — removed at any time
- →Does not prevent surgery later if needed
- →Safe for long-term use with regular review
- →Suitable during pregnancy planning and post-partum
Who Is a Pessary Suitable For?
A pessary is appropriate in a wide range of clinical situations. I commonly recommend one in the following circumstances.
Wish to Avoid Surgery
Many women prefer to manage prolapse without an operation. A pessary is an excellent long-term option and does not exclude surgery later if you change your mind.
Waiting for Surgery
A pessary can control symptoms effectively while you wait for an operation. Many women find this significantly improves their quality of life in the interim.
Medical Comorbidities
Some women are not suitable surgical candidates due to health conditions. A pessary offers effective symptom management without the risks of general anaesthesia or surgery.
Wish to Preserve Fertility
Women who have not completed their family may wish to defer surgery. A pessary can manage prolapse until the time is right for a definitive procedure.
Want Immediate Relief
Most women notice improvement the same day. A pessary provides relief immediately, without waiting for a surgical booking or recovery period.
Prefer Conservative Management
Some women simply prefer to try all non-surgical options first. This is always a reasonable approach, and I will support whichever pathway you choose.
Not everyone is suitable for every pessary type. Fitting depends on vaginal anatomy, prolapse compartment, severity and personal preference. I will assess you individually and recommend the most appropriate device. If one type is not comfortable, I will try an alternative at the same visit or at a follow-up appointment.
Types of Pessary I Offer
Pessaries are not one-size-fits-all. The device I recommend depends on your prolapse type, severity, anatomical findings and lifestyle. Below are the pessaries I use most commonly in clinical practice.
Most Commonly Used
Ring Pessary
The most widely used pessary type. A flexible silicone ring that sits behind the pubic symphysis and supports the upper vagina and pelvic organs. Comfortable for most women and straightforward to self-manage.
- Mild to moderate cystocele or uterine prolapse
- Active women who wish to continue exercise
- Women who want to manage their own pessary at home
- Women who wish to be sexually active with the pessary in situ
Enhanced Anterior Support
Ring Pessary with Support
A ring pessary with a central diaphragm that provides additional support to the anterior compartment. Recommended when a standard ring pessary does not adequately control bladder prolapse symptoms.
- Moderate cystocele with inadequate control on a ring alone
- Women requiring more anterior wall support
- Uterine prolapse with concurrent anterior wall descent
Advanced Prolapse Support
Cube Pessary
A cube-shaped pessary with concave faces that create suction against the vaginal walls, providing stronger support than a ring. Particularly useful in women with more advanced or multi-compartment prolapse.
- More advanced prolapse (POP-Q stage III–IV)
- Vault prolapse after hysterectomy
- Women who have not achieved adequate support with a ring
- Multi-compartment prolapse
Severe Prolapse · Maximum Support
Gellhorn Pessary
A mushroom-shaped pessary providing maximum apical support. The stem rests against the perineum and the dome supports the vault or cervix. Requires fitting in clinic and is generally not suitable for self-management.
- Severe uterine or vault prolapse
- Women for whom other pessary types have been inadequate
- Procidentia (complete uterine prolapse)
Selective Use · Advanced Cases
Shelf Pessary
A firm pessary with a shelf component used selectively in cases of advanced prolapse where other designs have not provided sufficient support. Fitting requires experience and regular clinic follow-up.
- Advanced or recurrent prolapse
- Cases where Gellhorn or cube has not been tolerated
- Women with a wide vaginal introitus reducing retention of softer devices
Clinical Guidance
Which Pessary Is Right for You?
The choice of pessary depends on your anatomy, the compartment prolapsed, the degree of prolapse and your preference for self-management. I always start with the simplest device that is likely to work.
If the first pessary chosen is not comfortable or does not stay in place, I will try an alternative at the same visit or at a follow-up appointment. This is routine and does not indicate that pessary treatment will not work for you.
Book an Assessment →What Happens at a Pessary Appointment?
Most women leave their first appointment with a pessary already fitted and immediate symptom relief. Appointments typically take 30–45 minutes from start to finish.
Step 1 — Consultation & History
I review your symptoms, their impact on daily life, previous treatments and any relevant medical history. I discuss all your options — including physiotherapy, pessary and surgery — so you can make an informed choice.
Step 2 — Pelvic Examination
A pelvic examination allows me to assess the type and degree of prolapse in each compartment, vaginal capacity and tissue health — all of which influence pessary selection.
Step 3 — Pessary Fitting
I select the most appropriate pessary type and size. Several sizes may be tried before the most comfortable fit is confirmed. You will stand, walk and cough to ensure the pessary stays in place with activity before you leave.
Step 4 — Self-Management Teaching (If Appropriate)
If you would like to manage your own pessary at home, I can teach you removal and reinsertion technique at the same appointment or at a follow-up visit.
Step 5 — Follow-Up
Follow-up is arranged at 4–6 weeks initially, then every 4–6 months. At each visit I assess comfort, symptom control, vaginal tissue health and pessary condition. Routine replacement or resizing is carried out as needed.
What to Expect
No special preparation is required. You may eat and drink normally. A chaperone will be offered for the examination.
Common Questions Before Your Appointment
- Will it hurt? Most women experience only mild discomfort. It is no more uncomfortable than a cervical smear.
- Will I feel it when it is in? A well-fitted pessary should not be noticeable during normal activity.
- Can I drive home afterwards? Yes. There is no anaesthetic or sedation involved.
- Can I go back to work the same day? Yes. Most women return to all normal activities immediately.
- What if it does not work? I will try an alternative size or type. Pessary management succeeds in the great majority of women.
No GP Referral Required
You can book directly into my pessary clinic at Spire Claremont or Circle Thornbury without seeing your GP first. Contact my secretary on 07990 251036 or admin@swatijha.com.
Benefits of Vaginal Pessary Treatment
Pessary treatment has a strong evidence base and suits a wide range of women with prolapse — from those who wish to avoid surgery altogether to those who need symptom control while they decide on next steps.
Immediate Symptom Relief
Most women notice improvement the same day the pessary is fitted. There is no waiting for surgical bookings or recovery periods.
Avoidance of Surgery
Many women manage prolapse with a pessary long-term and never require an operation. Surgery remains an option if needed later.
Fully Reversible
The pessary can be removed at any time and the decision is entirely yours. It does not commit you to any particular treatment pathway.
Maintains Active Lifestyle
Walking, gym exercise, swimming and travel are all possible with a well-fitted pessary. Many women find it enables activity they could not otherwise manage.
Safe Long-Term
With regular follow-up, pessary use is safe for many years. Complications are uncommon and detected early at routine review.
No Anaesthetic or Hospital Stay
Fitting and follow-up take place in outpatient clinic. There is no anaesthetic, no admission and no recovery time required.
Potential Side Effects and How They Are Managed
Vaginal pessaries are generally very safe when used with appropriate follow-up. Serious complications are uncommon. The most important factor in minimising risk is attending regular review appointments.
Possible side effects include:
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Increased vaginal discharge Common, particularly with cube pessaries. Usually clear or slightly discoloured and not indicative of infection. Manageable with simple hygiene advice.
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Vaginal irritation or discomfort Often related to an ill-fitting pessary or vaginal dryness. Adjusting size or adding vaginal oestrogen usually resolves this.
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Light vaginal bleeding Occasional spotting can occur, particularly in postmenopausal women with fragile vaginal tissue. Vaginal oestrogen significantly reduces this risk.
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Pessary expulsion The pessary may come out during activity or defaecation, particularly during the initial fitting period. A different size or type usually resolves this.
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Vaginal ulceration (if follow-up is missed) The most serious complication, caused by an ill-fitting or forgotten pessary left in place too long. Prevented entirely by attending regular follow-up appointments. This is why review appointments matter.
When to Contact Me Between Appointments
Contact my secretary if you experience any of the following before your next scheduled review:
- Significant pain or pressure from the pessary
- Heavy or unusual bleeding
- Offensive-smelling discharge suggesting infection
- Difficulty passing urine or opening your bowels
- Persistent difficulty removing the pessary if self-managing
Vaginal Oestrogen and Pessary Treatment
For postmenopausal women, I routinely recommend vaginal oestrogen alongside pessary treatment. This is one of the most effective ways to improve pessary tolerance, reduce complications and support long-term pelvic floor health.
After the menopause, declining oestrogen causes the vaginal tissues to become thinner, drier and more fragile — a condition called genitourinary syndrome of menopause (GSM). This makes pessary fitting more challenging and increases the risk of irritation and ulceration. Vaginal oestrogen applied locally reverses these changes.
Benefits of Vaginal Oestrogen Alongside a Pessary
- Improves vaginal tissue quality and elasticity
- Reduces pessary-related irritation and discharge
- Significantly lowers the risk of vaginal ulceration
- Improves comfort during follow-up examinations
- Supports overall pelvic floor health long-term
Is Vaginal Oestrogen Safe for Me?
Topical vaginal oestrogen works locally on vaginal tissue. At standard doses, systemic absorption is minimal — substantially lower than oral HRT or transdermal patches.
For most women — including many with a history of hormone-sensitive breast cancer — low-dose vaginal oestrogen is considered safe in the context of managing genitourinary symptoms. This is supported by current NICE guidance and the British Menopause Society.
I will review your individual medical history and discuss this with you specifically at your appointment.
Vaginal Oestrogen Preparations
Available in several forms including:
- Pessary tablets (e.g. Vagifem)
- Cream (e.g. Ovestin, Premarin)
- Vaginal ring (e.g. Estring)
- Gel (e.g. Blissel)
I will recommend the most suitable preparation based on practicality and your preference.
Can I Remove and Reinsert My Own Pessary?
Yes — and for many women, self-management is the ideal long-term approach. I routinely train women to remove and reinsert their own ring pessary at home. This is practical, straightforward and takes most women only a few minutes once the technique is learned.
Advantages of Self-Management
- You can remove the pessary before sex and reinsert it afterwards
- You can remove it for comfort during certain activities if preferred
- You maintain vaginal hygiene more easily
- You become less dependent on clinic visits for routine changes
- You can recognise early problems with fit and seek advice promptly
Most women who self-manage continue to attend a clinic review every 6–12 months to have the vaginal walls examined and the pessary inspected.
Is Self-Management Right for Me?
Self-management is suitable for most women using a ring pessary who are comfortable with the idea. It is not appropriate for all pessary types — cube, Gellhorn and shelf pessaries generally require clinical removal.
At your appointment, I will:
- Assess whether your pessary type is suitable for self-management
- Demonstrate removal and insertion technique
- Allow you to practise under supervision before leaving
- Provide written instructions to take home
There is no pressure to self-manage. If you prefer clinic-managed follow-up, that is equally appropriate and I will arrange your review schedule accordingly.
Why Patients Choose My Sheffield Pessary Clinic
Most local services offer pessary fitting as an add-on to a general gynaecology outpatient list. I offer a dedicated pessary clinic with consultant-led assessment, the full range of pessary types and structured long-term management — no handoffs, no generic care pathways.
Consultant-Led Throughout
I personally assess every patient. The clinician who examines you, selects your pessary and fits it is the same person managing your follow-up. No registrar-led clinics.
RCOG Subspecialty Accreditation
The highest level of urogynaecology training available in the UK. I direct the only RCOG-accredited urogynaecology training programme in Yorkshire.
Full Range of Pessary Types
I offer ring, ring with support, cube, Gellhorn and shelf pessaries. If one device does not suit you, I try the next. A failed first fit is not a failed pessary clinic.
Long-Term Pessary Management
I offer ongoing follow-up for women managing prolapse with a pessary long-term — not just initial fitting and discharge. This is a clinical relationship, not a procedure.
Integrated Treatment Pathway
If a pessary is not sufficient, or if you decide surgery is the right next step, the same clinician manages your entire journey. You do not need to be referred elsewhere.
Over 15 Years’ Prolapse Expertise
150+ peer-reviewed publications. Honorary Professor, University of Sheffield. Clinical expertise informed by active research in urogynaecology and pelvic floor disorders.
How Do I Decide Between a Pessary and Surgery?
There is no single right answer — and for most women, starting with a pessary is the sensible approach regardless of whether surgery is planned eventually. It is low-risk, effective and reversible. It also gives you time to decide.
A pessary is usually the better starting point when:
- You are not yet sure whether you want surgery
- You have medical conditions that increase surgical risk
- You are hoping to have children in the future
- Your symptoms are well-controlled and not significantly affecting quality of life
- You are on a surgical waiting list and need symptom relief now
Surgery is usually the better option when:
- Pessary fitting has failed or the pessary cannot be retained
- You have had successful pessary management but want a more permanent solution
- Prolapse is severe and not adequately controlled by a pessary
- Symptoms significantly affect quality of life despite pessary use
- You prefer a one-time definitive anatomical correction
These are not rigid rules. I will discuss both options clearly and without bias, and support whatever decision you make.
A Pessary Does Not Burn Bridges
Using a pessary does not reduce the effectiveness of surgery if you choose it later. It does not alter your anatomy in a way that makes surgical repair more difficult. Many women use a pessary for years and then opt for surgery when the time is right.
Equally, having surgery does not prevent you from using a pessary again if prolapse recurs or if symptoms return after an operation.
Further Reading
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Prolapse Surgery Sheffield
All surgical procedures available for vaginal prolapse
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Vaginal Prolapse Treatment Sheffield
Overview of the full treatment pathway from diagnosis
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Non-Surgical Prolapse Treatment Sheffield
Physiotherapy, pessary and lifestyle — the conservative pathway
How to Book a Pessary Appointment in Sheffield
No GP referral is required. Contact my secretary directly to arrange a pessary assessment at Spire Claremont Hospital or Circle Thornbury Hospital, Sheffield.
Contact My Secretary
Ms Lauren Hudson
07990 251036 admin@swatijha.comAppointments available Tuesday and Friday at both hospitals.
Where I See Patients in Sheffield
Pessary assessments and follow-up appointments take place at two CQC-registered private hospitals in Sheffield.
Frequently Asked Questions — Vaginal Pessary
What is a vaginal pessary?
A vaginal pessary is a soft silicone device inserted into the vagina to support prolapsed pelvic organs. It acts as an internal support structure, reducing symptoms of vaginal bulge, pelvic heaviness, and bladder or bowel dysfunction caused by prolapse.
Is pessary fitting painful?
Most women experience only mild discomfort during fitting. The procedure is performed in clinic without anaesthetic. Several sizes may be tried before the most comfortable fit is achieved. Most women leave with a pessary already in place and notice improvement the same day.
Can a pessary stop me needing surgery?
Yes. Many women successfully manage prolapse long-term with a pessary and never require an operation. Pessary management does not prevent surgery later if it becomes necessary, but for a large proportion of women it provides sufficient symptom control indefinitely.
How often does a pessary need changing?
Usually every 4–6 months, depending on pessary type and individual circumstances. Women who manage their own pessary independently may change it more frequently. Regular follow-up allows the vaginal walls to be inspected and ensures the pessary remains comfortable and effective.
Can I exercise with a pessary in place?
Yes. Most women can continue normal activities including walking, gym exercise, swimming and travel with a pessary in place. Some women find the pessary is more comfortable during high-impact exercise than their prolapse symptoms were without one.
Can I have sexual intercourse with a pessary?
Many ring pessaries can remain in place during intercourse. Some women prefer to remove the pessary beforehand and reinsert it afterwards. I will advise on the most practical approach based on pessary type and individual preference.
Do pessaries cause infections?
Serious infection is uncommon. Increased vaginal discharge is a recognised side effect and does not usually indicate infection. Regular follow-up allows early identification of any vaginal changes. Good hygiene and regular reviews minimise risk.
Can a pessary fall out?
Occasionally. Pessary expulsion usually indicates that a different size or type is required. At follow-up I reassess the fit and adjust accordingly. Most women find a size that stays comfortably in place with normal activity.
Can I manage my own pessary at home?
Yes. Some women learn to remove and reinsert their own ring pessary at home. I can train you in this technique at clinic. Self-management allows greater flexibility with hygiene and sexual activity. Not all pessary types are suitable for self-management — I will advise which is most practical for you.
Is vaginal oestrogen safe alongside a pessary?
For most postmenopausal women, topical vaginal oestrogen is safe alongside pessary treatment. At low doses it acts locally on vaginal tissue and systemic absorption is minimal. It significantly improves tissue health, pessary comfort and tolerance. I will discuss this individually, including for women with a history of hormone-sensitive cancer, where low-dose topical oestrogen is considered safe in many circumstances.
What if my pessary does not work?
If one pessary type is unsuccessful, I will try an alternative before concluding that pessary management is not suitable. If fitting fails or symptoms remain inadequately controlled, I will discuss surgical options with you. Most women find at least one pessary type that controls their symptoms well.
How much does pessary fitting cost in Sheffield?
Initial consultation is £205. Follow-up appointments are £125 and include pessary review and replacement as needed. Fees may be covered by private medical insurance. No GP referral is required. Contact admin@swatijha.com or call 07990 251036 to enquire.
What if my prolapse worsens despite a pessary?
If pessary management no longer provides adequate control, I will reassess and discuss surgical options. Having used a pessary does not limit your surgical choices. Many women who proceed to surgery continue to find the pessary useful while awaiting their operation.
Do I need a GP referral for pessary fitting in Sheffield?
No. You can self-refer directly to my private pessary clinic in Sheffield without a GP referral. Contact admin@swatijha.com or call 07990 251036. Appointments are available on Tuesday and Friday at Spire Claremont Hospital and Circle Thornbury Hospital.