Skip to main content

Urogynaecology · UK

Pessary insertion - prolapse supported, without surgery.

A soft silicone device, fitted in minutes without anaesthetic, that lifts a prolapsed bladder, womb or bowel back into place. Fitted by a urogynaecology specialist, sized properly, and reviewed on a schedule that actually happens.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private pessary care costs in the UK.

Indicative ranges across UK urogynaecology clinics.

In short

£250–£500, done in one visit.

Item Indicative range
Pessary fitting with urogynaecology consultation £250–£500
Pessary change / routine review £120–£250
Ring pessary (device) £20–£60
Gellhorn or shelf pessary (device) £30–£80
Self-management teaching session £100–£200
Pelvic floor physiotherapy (per session) £60–£120
Prolapse surgery consultation (if chosen later) £250–£450

Pessary care is one of the most affordable things in gynaecology - the devices themselves cost tens of pounds, and the value sits in expert fitting and reliable reviews. On the NHS this care is available and free, though appointment intervals can stretch; private care buys specialist hands, the full device range and a schedule that keeps.

The problem

The right device, a fit that holds, and reviews that actually happen.

Prolapse care quietly under-delivers in three places - women never offered a pessary at all, rings fitted where a Gellhorn was needed, and change appointments that drift for years. We fix all three.

  • A real option, properly offered

    Pessaries are not a consolation prize for women “not suitable” for surgery - for many they are the best answer, and they deserve a proper fitting service.

  • Type and size chosen for your life

    Whether you want intercourse, self-management, or maximum hold decides the device as much as the anatomy does. That conversation comes first.

  • The schedule is the safety

    Almost every pessary problem is a neglected pessary. Changes every 4–6 months - or taught self-management - is the entire risk plan, and we make sure it exists.

When it helps

When a pessary is the right step.

The situations we see most, plus the one warning sign that needs a prompt review rather than the next routine change.

  • A dragging sensation or visible bulge

    The classic symptoms of pelvic organ prolapse - heaviness by evening, a bulge at or beyond the entrance, discomfort on standing.

  • Prolapse affecting the bladder or bowel

    Difficulty emptying, a slow stream, needing to press on the bulge to empty - support often improves all three.

  • Wanting to avoid or delay surgery

    A pessary controls symptoms without an operation - indefinitely for many women, or as a bridge while surgery is considered.

  • Not finished having children

    Prolapse surgery is best deferred until the family is complete. A pessary carries you comfortably through the years between.

  • Unfit or unwilling for an operation

    When anaesthetic risk is high or surgery is simply unwanted, a well-fitted pessary is a genuinely good long-term answer.

  • Symptom relief during pregnancy

    Prolapse and cervical support in pregnancy is a specialist niche - pessaries have a role, fitted by the right hands.

  • A trial before deciding on surgery

    If a pessary relieves your symptoms, surgery probably will too - a genuinely useful predictive test.

  • Red flag: bleeding or a pessary you cannot remove

    Vaginal bleeding, offensive discharge, pain, or a forgotten pessary that will not come out needs prompt gynaecology review - neglected pessaries can erode the vaginal wall.

Pessary types

The device depends on the prolapse - and on your life.

What each option involves - the everyday ring, the stronger space-occupying designs, self-management, and the alternatives that stay on the table.

  • Ring pessary

    The first choice for most women - a flexible ring sitting behind the pubic bone and holding the walls up. Comfortable, allows intercourse, easy to self-manage.

  • Ring with support membrane

    A ring with a diaphragm across it - adds support for the womb or vault where a plain ring is not quite enough.

  • Gellhorn pessary

    A stem-and-disc device for more advanced prolapse that a ring will not hold. Very effective; intercourse is not possible with it in place.

  • Shelf pessary

    A similar space-occupying design for significant uterine or vault prolapse - a workhorse in older women managing without surgery.

  • Cube and donut pessaries

    Options for difficult-to-hold prolapse or a widened opening - the cube grips by gentle suction and needs daily removal.

  • Self-management

    Many women learn to remove, wash and reinsert a ring themselves - freedom from clinic schedules, and kinder to the vaginal skin.

  • Vaginal oestrogen alongside

    After menopause, low-dose local oestrogen keeps the vaginal skin resilient under the pessary and halves irritation problems.

  • Physiotherapy and surgery

    Pelvic floor training helps mild prolapse in its own right; surgical repair is the definitive option. Both stay on the table at every review.

Safety and daily life

What life with a pessary is really like - honestly.

Pessaries are among the safest treatments in gynaecology. The things worth planning are the fit, the skin, and the change schedule.

  • No anaesthetic, no downtime

    Fitting takes minutes in clinic and feels like a smear-test level of discomfort. You drive home, work the same day, and exercise as normal once settled.

  • Finding the right size can take two or three goes

    Around a third of first fittings need an early size change - the pessary drops, or presses. This is entirely normal and quickly sorted.

  • Discharge and odour

    A modest increase in discharge is common and harmless. Offensive odour suggests the pessary is overdue a change or the skin needs attention - a review, not alarm.

  • Irritation and minor bleeding

    The device can rub, particularly on oestrogen-deficient skin. Spotting warrants a check; vaginal oestrogen usually prevents recurrence.

  • Erosion - the risk of neglect

    A pessary left unchanged for years can embed and erode the vaginal wall. The entire risk is managed by the 4–6-monthly change schedule - which we make sure exists.

  • Bladder and bowel effects

    Support sometimes unmasks stress incontinence that the prolapse was hiding. Worth knowing in advance - and treatable.

  • Sex and exercise

    A ring pessary allows intercourse; Gellhorn and shelf types do not. Running, lifting and swimming are all compatible with a well-fitted pessary.

  • It does not fix the prolapse

    A pessary supports rather than repairs. Symptoms return when it is out - which is fine, so long as that is the deal you knowingly chose.

  • Red flags

    Fresh bleeding, pain, difficulty passing urine, or a pessary you cannot remove need a prompt gynaecology appointment - not the next routine change.

Reading your clinic letter

Your clinic letter in four parts. Read the last one first.

Whichever device was fitted, the letter the clinic sends after each visit keeps to the same shape.

A UK urogynaecology specialist reviewing a patient’s clinic notes

A quiet reminder

Gynaecology language is precise and can read coldly - ask your care team to explain anything that is unclear.

Ask your care team to explain anything that is unclear.

  1. 01 Header

    Prolapse stage and compartments

    What was found on examination - which walls or organs descend (bladder, womb, bowel) and how far, staged formally.

  2. 02 Technique

    Pessary type and size

    The device fitted - ring, Gellhorn, shelf - its size, and any earlier sizes tried. The single most useful line for every future change.

  3. 03 Findings

    Skin condition and oestrogen plan

    The state of the vaginal skin, whether local oestrogen was prescribed, and anything needing surveillance.

  4. 04 Impression

    Change schedule and the longer plan

    Read this first: when the next change is due, whether you are self-managing, and where physiotherapy or surgery sit in your longer-term plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Urogynaecology assessment and pessary fitting are usually covered when prolapse is symptomatic.

Frequently asked

Everything we get asked about pessaries.

Quick answers on comfort, changes, sex and exercise, cost and the surgical question.

  • What is a pessary and how does it work?

    A vaginal pessary is a soft silicone device inserted into the vagina to support pelvic organs that have prolapsed - the bladder, womb or bowel pressing into the vaginal walls. It works purely mechanically, holding the walls up so the dragging sensation and bulge disappear while it is in place. Fitting takes minutes in clinic and needs no anaesthetic.

  • Is having a pessary fitted painful?

    Most women describe it as uncomfortable rather than painful - similar to a smear test. The pessary is folded for insertion and opens into place; once correctly sized, you should not be able to feel it at all during daily life. If you can feel it, it is the wrong size or type, and refitting is quick.

  • How often does a pessary need changing?

    Clinic-managed pessaries are usually removed, washed or replaced every four to six months, with the vaginal skin checked at each visit. Many women with ring pessaries learn to manage the device themselves - removing and reinserting it weekly or before intercourse - which offers more freedom and is kind to the skin. What matters most is that a schedule exists: neglected pessaries cause problems, well-managed ones very rarely do.

  • Can I have sex, exercise and swim with a pessary in?

    With a ring pessary, yes to all three - most partners are unaware of it. Space-occupying pessaries such as the Gellhorn and shelf do not allow intercourse, which is exactly why the choice of device is a conversation about your life, not just your anatomy. Exercise, running and swimming are all fine once the fit has settled.

  • How much does private pessary fitting cost in the UK?

    A consultation with fitting typically costs £250–£500, routine changes £120–£250, and the devices themselves £20–£80. On the NHS, pessary care is available through GPs and gynaecology clinics and works well, though appointment intervals can stretch; private care mainly buys specialist fitting, the full range of devices, and reviews that happen when they should.

  • Is a pessary just putting off inevitable surgery?

    No. Long-term studies show many women use a pessary happily for years or decades with no operation ever needed, and satisfaction rates rival surgery for the right candidates. Others use it as a comfortable bridge - while completing their family, awaiting surgery, or deciding. And a pessary trial has genuine predictive value: if it relieves your symptoms, surgical repair is likely to as well.

Related treatments

Looking for something else?