Skip to main content

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.

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 fitting costs in the UK.

Indicative ranges across UK urogynaecology clinics.

In short

Consultation with a ring fitting: £350–£650, home the same appointment.

Service Indicative range
Urogynaecology consultation only £220–£400
Consultation with pessary fitting (ring) £350–£650
Shelf or Gellhorn (space-filling) fitting £400–£750
Pessary change and clean (routine) £120–£250
Self-management teaching session £150–£300
Vaginal oestrogen review add-on £80–£150
Annual pessary care package £350–£600

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.

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.

  • Try more than one shape

    Prolapse is not one thing. If a ring will not hold, a shelf, Gellhorn or cube might - a clinic with a range of pessaries can try them 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. Setting the schedule and reminders on day one, not after a problem appears, is good practice.

When it helps

When a pessary is the right step.

The situations that come up 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.

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.

  • Effect on bladder and bowel

    Support can occasionally unmask stress incontinence or make bladder emptying feel different.

  • 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 reminders and a written record help.

  • 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 UK urogynaecology specialist reviewing a patient’s clinic notes

A quiet reminder

Clinical language is precise and can read coldly - it is fine to ask for plain English.

It is reasonable to ask your clinician to talk you through the fitting note and your care plan before your review.

  1. 01 Header

    Prolapse type and grade

    Which compartment is prolapsing - front wall, back wall, uterus or vault - and how far it descends on examination.

  2. 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.

  3. 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.

  4. 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

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Pessary fitting for symptomatic prolapse is usually covered when medically indicated, though some insurers treat outpatient device care as a self-pay item.

Frequently asked

Common questions 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, a clinician 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.

  • 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; private care is sometimes chosen when waiting times or continuity matter.

Related treatments

Looking for something else?