Concierge urogynaecology · UK
Vaginal pessary fitting - prolapse relief without surgery.
A small, soft device that supports a prolapse and lifts the heaviness away - fitted awake in clinic in a single appointment. A urogynaecologist who fits every week, the full range of pessary types tried on the day, and self-management taught where it suits you.
Why patients choose us
- 01
A urogynaecologist who fits, not a general list
A named consultant or specialist nurse who fits pessaries every week - sizes properly, checks the fit, and knows when a pessary is the wrong answer. No rushed ten-minute slot.
- 02
The full menu of pessary types, tried on the day
Ring, shelf, Gellhorn, cube, donut - the right shape depends on your prolapse and your anatomy. We keep a range in clinic so you leave with one that actually holds.
- 03
Independent, and free
We are paid by no clinic, so the advice - including whether surgery or physiotherapy might suit you better - is impartial and costs you nothing.
Indicative pricing
What private pessary fitting costs in the UK.
Indicative ranges across our partner urogynaecology clinics. Send the details and we quote firm figures, including ongoing care, with cover checked.
In short
Consultation with a ring fitting: £350–£650, home the same appointment.
| Service | Indicative range | Typical duration | Attendance |
|---|---|---|---|
| Urogynaecology consultation only | £220–£400 | 30–45 min | Same visit |
| Consultation with pessary fitting (ring) | £350–£650 | 30–45 min | Same visit |
| Shelf or Gellhorn (space-filling) fitting | £400–£750 | 30–60 min | Same visit |
| Pessary change and clean (routine) | £120–£250 | 15–20 min | Same visit |
| Self-management teaching session | £150–£300 | 30–45 min | Same visit |
| Vaginal oestrogen review add-on | £80–£150 | 10–15 min | Same visit |
| Annual pessary care package | £350–£600 | Per year | 2–3 visits |
Prices vary by clinic, by whether a specialist nurse or consultant fits the pessary, and by the type of device. Space-filling pessaries and ongoing care packages sit at the top of the range. We come back with a firm quote within one working day.
The problem
The right pessary, fitted properly, with care that continues.
Pessary care is where general clinics quietly under-deliver - one size tried and abandoned, no oestrogen, no follow-up. We fix all three, so the pessary actually holds and keeps working.
-
Try more than one shape
Prolapse is not one thing. If a ring will not hold, a shelf, Gellhorn or cube might - we keep a range in clinic and try until one works.
-
Protect the tissue with oestrogen
Vaginal oestrogen keeps the skin supple and cuts the risk of erosion. It is a small addition that makes a long-term pessary far more comfortable.
-
Book the follow-up before you leave
A pessary needs checking and cleaning. We set the schedule and the reminders on day one, not after a problem appears.
The journey
From enquiry to a pessary that holds - what happens, in order.
One team from first message through fitting, first review and ongoing changes.
Phase 1 · Before your fitting
Assessment and examination
Phase 2 · On the day
Fitting and comfort check
Phase 3 · After
Review, cleaning, oestrogen
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, how long, any bulge or heaviness, bladder or bowel changes, and whether you have tried physiotherapy or a pessary before.
- 02
Before
We come back with a recommendation
Within one working day: whether a pessary is likely to suit you, which type is the sensible first choice, an indicative price, and whether physiotherapy or surgery deserves a look first.
- 03
Before
Assessment and examination
A urogynaecology consultation with a pelvic examination to grade the prolapse and confirm a pessary is appropriate. Bladder symptoms and any bleeding are checked before fitting.
- 04
On the day
The fitting appointment
The clinician measures and inserts a trial pessary, then asks you to stand, cough and walk. If it slips or is uncomfortable, they try another size or shape until one holds and feels right.
- 05
On the day
Comfort and self-care check
You empty your bladder and bowel with the pessary in to be sure it stays put. Where suitable, we teach you to remove and reinsert it yourself. You go home the same appointment.
- 06
After
First review
A review at 1–2 weeks to check comfort, that it has not moved, and that there is no rubbing or discharge. Any early problem is sorted before it becomes a nuisance.
- 07
After
Ongoing changes and cleaning
A ring pessary is typically checked and cleaned every 4–6 months; some women manage their own. Vaginal oestrogen is often added to keep the tissue healthy.
Typical end-to-end: days, not weeks from enquiry to fitting. Ongoing care: a check every 4–6 months.
When it helps
When a pessary is the right step.
The situations we see most, plus the one red flag that means a prompt review rather than a routine wait.
-
Vaginal bulge or heaviness
A dragging sensation or a bulge you can feel or see - the commonest reason women seek a pessary, and one it often relieves well.
-
Cystocele (front-wall prolapse)
The bladder pushing into the front vaginal wall, sometimes with urinary frequency or incomplete emptying.
-
Uterine or vault prolapse
The uterus, or the vaginal vault after hysterectomy, descending - a space-filling pessary can lift and support it.
-
Rectocele (back-wall prolapse)
The bowel bulging into the back vaginal wall, sometimes with difficulty emptying the bowel.
-
A non-surgical choice
For women who would rather avoid an operation, or who want relief now while they decide about surgery later.
-
Not fit for, or wanting to delay, surgery
Where an anaesthetic carries extra risk, or family or work means surgery has to wait, a pessary bridges the gap.
-
Prolapse in pregnancy or postnatally
A supportive pessary can help symptomatic prolapse during pregnancy or the early postnatal months while the pelvic floor recovers.
-
Red flag: bleeding, pain or discharge
New vaginal bleeding, pelvic pain, or a foul discharge with a pessary in place needs prompt review - a neglected pessary can erode the vaginal wall.
Pessary types
The shape depends on the prolapse and your anatomy.
What each option involves - support pessaries you can often manage yourself, and space-filling shapes for more advanced prolapse.
-
Ring pessary
The first-choice support pessary for most prolapse. Easy to insert, often self-managed, and compatible with sexual activity. Comes with or without a support membrane.
-
Ring with support
A ring with a perforated diaphragm, useful when a plain ring does not hold a cystocele. Still often self-managed.
-
Shelf pessary
A space-filling pessary for more advanced prolapse where a ring will not stay in. Usually clinician-managed and removed for intercourse.
-
Gellhorn pessary
A stemmed, space-filling device for significant uterine or vault prolapse. Holds firmly; fitted and changed by the clinician.
-
Cube pessary
Uses suction to grip the vaginal walls for prolapse that other shapes cannot hold. Must be removed nightly to protect the tissue.
-
Donut pessary
A thick ring for advanced prolapse, offering more bulk than a standard ring. Generally clinician-managed.
-
Incontinence (knob) pessary
A ring with a knob that supports the bladder neck to reduce stress urinary incontinence, with or without prolapse.
-
Cube and shelf with oestrogen
Space-filling shapes combined with vaginal oestrogen, which keeps the tissue supple and cuts the risk of erosion.
Our vetted UK network
A small panel of pelvic-health specialists, we picked them.
Consultant urogynaecologists and specialist pelvic-health nurses across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinician in our network.
-
Consultant urogynaecologists and specialist pelvic-health nurses who fit pessaries routinely
-
A full range of pessary types and sizes stocked in clinic, so fitting is done the same visit
-
Vaginal oestrogen prescribing and self-management teaching offered as standard
-
Clear onward pathways to pelvic-floor physiotherapy or prolapse surgery where a pessary is not the answer
Safety and self-care
What to expect afterwards - honestly.
A pessary is a safe, well-established treatment. The things worth planning are the right shape, protecting the tissue, and keeping to the change schedule.
-
No anaesthetic, done in clinic
A pessary is fitted awake in an outpatient room. There is no theatre, no sedation and no recovery ward - you walk in and walk out the same appointment.
-
Finding the right size takes trying
It is normal to try two or three sizes or shapes before one holds. A little trial and error at the first visit is expected, not a sign anything is wrong.
-
Discharge and odour
Increased vaginal discharge is the commonest side effect. Regular cleaning, vaginal oestrogen and routine changes keep it in check.
-
Vaginal erosion or ulceration
A pessary that rubs can cause a sore on the vaginal wall. Caught early it settles with a rest period and oestrogen; a neglected pessary is the main preventable risk.
-
Expulsion and slippage
A pessary can drop out, especially when straining or opening the bowels. If it keeps coming out, the type or size needs changing - tell us rather than giving up.
-
Effect on bladder and bowel
Support can occasionally unmask stress incontinence or make bladder emptying feel different. We check emptying at the fitting and adjust if needed.
-
Vaginal oestrogen usually helps
For post-menopausal women, low-dose vaginal oestrogen keeps the tissue healthy, improves comfort and reduces erosion. It is a local treatment, not systemic HRT.
-
Keep to the change schedule
Clinician-managed pessaries need changing every 4–6 months. Forgetting is the single biggest cause of serious problems, so we set reminders and keep a record.
-
Red flags to call about
New bleeding, pain, a pessary you cannot remove, difficulty passing urine, or a heavy offensive discharge need the same-week team, not a routine wait.
Reading your clinic note
Your fitting note in four parts. Read the last one first.
Whichever pessary was fitted, the note your clinician sends you keeps to the same shape.
A quiet reminder
Clinical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the fitting note and your care plan before your review, just ask.
- 01 Header
Prolapse type and grade
Which compartment is prolapsing - front wall, back wall, uterus or vault - and how far it descends on examination.
- 02 Fitting
Pessary type and size
The shape and size fitted, how it was tested (standing, coughing, walking) and whether bladder emptying was confirmed with it in place.
- 03 Findings
Tissue condition and oestrogen
The state of the vaginal skin, any thinning or early erosion, and whether vaginal oestrogen has been started to protect it.
- 04 Plan
Change schedule and self-care
Read this first: when to come back, whether you can manage the pessary yourself, and what to do if it slips or feels uncomfortable.
Recognised by major UK insurers
Pessary fitting for symptomatic prolapse is usually covered when medically indicated, though some insurers treat outpatient device care as a self-pay item. We confirm cover before booking.
Frequently asked
Everything we get asked about pessaries.
Quick answers on comfort, sex, cleaning, cost and the NHS route.
-
Does having a pessary fitted hurt?
Fitting is done awake in clinic and should not be painful - most women describe it as similar to a smear examination, with a moment of pressure as the pessary goes in. If it feels uncomfortable once in place, that usually means the size or shape is not right, and the clinician simply tries another. You should not leave with a pessary that hurts.
-
Can I still have sex with a pessary in?
With a ring pessary, yes - most couples find intercourse comfortable and the ring can stay in. Space-filling pessaries such as a shelf, Gellhorn or cube usually need to be removed for intercourse. If you can manage your own pessary, this is straightforward; if not, we can talk through the options.
-
How often does a pessary need changing?
A ring pessary is typically checked and cleaned every 4–6 months, either by you if you self-manage or in clinic. Space-filling pessaries are generally clinician-changed on a similar schedule, and a cube pessary is removed every night. Keeping to the schedule is the single most important thing you can do to avoid problems.
-
Will a pessary cure my prolapse?
No - a pessary supports the prolapse and relieves the symptoms rather than repairing the anatomy. Many women use one happily for years and never need surgery. Others use one for relief while they decide about an operation, or during pregnancy and the postnatal period. If you want a permanent repair, prolapse surgery is the route.
-
How much does private pessary fitting cost in the UK?
Expect roughly £220–£400 for a urogynaecology consultation alone, £350–£650 for a consultation with a ring fitting, and £400–£750 for a shelf or Gellhorn fitting. Routine changes are around £120–£250, and an annual care package covering two to three visits is typically £350–£600. We confirm a firm figure within one working day.
-
What is the NHS route, and why go private?
The NHS fits pessaries and provides ongoing changes, usually through a urogynaecology or specialist nurse clinic, and this is a well-established service. The main differences privately are speed - often a fitting within days rather than a wait - continuity with the same clinician, and a longer appointment with the full range of pessary types tried on the day. For many women the NHS route is entirely appropriate; we help when waiting or continuity matters.
Related treatments
Looking for something else?
-
Pelvic floor repair
Surgical repair of prolapse when you want a permanent fix.
Learn more -
Pelvic floor physiotherapy
Muscle training that can ease early prolapse.
Learn more -
Pessary insertion
Our overview of insertion and ongoing care.
Learn more -
Hysterectomy
Uterus removal, sometimes chosen for uterine prolapse.
Learn more -
Menopause clinic
Vaginal oestrogen and HRT to protect the tissue.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more