Pelvic Organ Prolapse · Patient guide

Pessary for Uterine Prolapse: Does It Work and for How Long?

Yes, a pessary works for uterine prolapse in the sense that it holds the uterus up and relieves the bulge and pressure for most women while it is in place; it does not repair the stretched ligaments or vaginal wall, so the prolapse returns when it is removed. It is a sound first-line choice, and Dr. Yoon at Somssi Women's Clinic in Seoul discusses it alongside uterus-preserving surgery.

Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026

At a glance

Key facts

The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.

• What it does: supports the cervix and uterus from inside the vagina; symptom relief while worn
• What it does not do: repair ligaments, vaginal wall or pelvic floor
• Common types: ring (often self-managed), Gellhorn and cube for advanced prolapse
• Fitting: in clinic, no anesthesia; may take more than one try
• Typical side effects: discharge, odor, irritation, erosion, expulsion
• Surgical alternative at Somssi: vaginal hysteropexy, about 1 hour, same-day discharge
• Who advises: Dr. Yoon Ho-joo, MD, PhD, Korean Society of Urogynecology member

A pessary does work for uterine prolapse: a correctly fitted device lifts the cervix back into the vagina and relieves heaviness, bulging and bladder pressure in most women who can retain one. What it cannot do is repair the ligaments and vaginal wall that let the uterus drop, so its effect lasts exactly as long as you wear it. Whether that is enough depends on your stage, your tissues and what you want from treatment.

How a pessary supports a dropped uterus

Uterine prolapse happens when the uterosacral and cardinal ligaments that suspend the uterus, and the vaginal wall and pelvic floor beneath it, stretch and thin. The cervix slides down the vaginal canal, sometimes to the opening or beyond. A pessary is a silicone device placed in the upper vagina that braces against the pelvic sidewalls and holds the cervix up.

For mild and moderate descent, a ring pessary is usually tried first. It is easy to insert and remove, and many women learn to manage it themselves. For more advanced uterine prolapse, or when a ring will not stay in, a space-filling Gellhorn or cube pessary is used; these generally need clinic removal and cleaning.

How well does it work?

Across published series, a majority of women with uterine prolapse can be fitted successfully, and most of those who are fitted report meaningful relief of the bulge, pressure and dragging sensation. Bladder emptying often improves because the urethra is no longer kinked by the descended uterus.

Continued use is the weaker point. A meaningful proportion of women stop within the first year or two, most often because the device falls out, causes discharge or irritation, is awkward to manage, or because they decide they would rather have a permanent repair. Women with a wide vaginal opening, a short vagina or weak pelvic floor muscles are the most likely to struggle to retain a pessary; these are the very features that often accompany uterine descent after childbirth.

Who is a pessary particularly good for?

• Women who are still planning pregnancies and want to defer surgery.
• Women with heart, lung or other conditions that make anesthesia and surgery unwise.
• Women with early prolapse whose symptoms are occasional, for example only after a long day on their feet.
• Women who want to test whether lifting the uterus relieves their symptoms before committing to an operation.
• Women who, after hearing both options, simply prefer not to have surgery. That preference is valid.

Side effects and care

A pessary sits in a warm, moist space, so increased discharge and sometimes odor are common. After menopause the vaginal lining is thinner, and the device can cause small erosions or spotting; vaginal estrogen cream usually prevents this. Infection is uncommon with regular cleaning. A neglected pessary, left in for months or years without checks, can embed in the tissue and in rare cases cause fistula, which is why follow-up matters.

Practical routine: self-managing women remove, wash and reinsert the ring every night or every few days; women who cannot self-manage attend the clinic every few months for removal, inspection and cleaning. If you are considering a permanent repair and already use a device, see vaginal ring (pessary) removal.

Where a pessary falls short for uterine descent

Uterine prolapse rarely occurs alone. The posterior vaginal wall is usually lax and thinned, the pelvic floor at the opening is weakened, and a pouch behind the cervix (the cul-de-sac) may be open. A pessary holds the uterus up but leaves all of that unchanged. For women whose complaints include looseness, reduced sensation, recurrent vaginitis from pooled secretions or a feeling of the "bottom falling out," a device addresses only part of the problem.

Somssi Women's Clinic, a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD, approaches uterine descent as a structural problem of the whole posterior compartment. Its uterine prolapse surgery lifts and fixes the uterus (hysteropexy), closes the cul-de-sac, thickens the posterior wall with the patient's own tissue and strengthens the pelvic floor, in about an hour under sedation and local anesthesia with same-day discharge. The clinic's view is that this restores support more completely and more durably than a pessary, and it regards pessaries as a second choice for women who are fit for surgery. International guidelines, by contrast, continue to present pessaries as an appropriate first-line option, and both perspectives should be on the table when you decide.

A sensible way to decide

1. Get staged. Know whether your uterus sits above the opening, at it, or beyond it, and whether the front or back wall has also dropped. See the stages of uterine prolapse.
2. Try a pessary if you want to. A few weeks with a ring tells you how much relief lifting the uterus brings, with no commitment.
3. Review honestly. If the pessary stays in, feels fine and solves your symptoms, keep it. If it falls out, irritates, or you dislike managing it, you now know that restoring support helps and can consider surgery with confidence.
4. Ask about uterine preservation. If you move to surgery, you do not have to lose your uterus. Read hysteropexy vs hysterectomy.

When to see a doctor

Book an assessment if you can feel the cervix at or outside the opening, if a pessary causes bleeding or pain, if it keeps falling out, or if you cannot pass urine normally. Our international patient team can arrange an English-language examination that covers both a pessary and surgical options in one visit.

Bottom line

A pessary works as long as it is worn and is a legitimate, low-risk first step for uterine prolapse, especially if you want to avoid or delay surgery. It does not repair the support, and many women eventually move on from it. If you want a lasting result that also addresses the vaginal wall and pelvic floor, uterus-preserving hysteropexy is the alternative to discuss.

Questions patients ask

Frequently asked questions

Short, honest answers. For anything personal, a consultation is the right place to ask.

See the full FAQ →

Can a pessary push the uterus back into place permanently?

No. It holds the uterus up while in position, but the ligaments do not shorten or strengthen in response. When the pessary is removed the uterus descends again. Only surgery changes the underlying support.

How long does it take to get used to a pessary?

Most women stop noticing a well-fitted ring within a few days. If you can feel it constantly, if it causes pain, or if it slips when you strain, the size or type is probably wrong and should be refitted rather than tolerated.

Can I exercise with a pessary in?

Yes, and many women find exercise more comfortable with one in. Some use a pessary only for sport or long days on their feet. If it falls out with exertion, a different size or type may hold better.

Does a pessary work after menopause?

It can, but the thinner postmenopausal vaginal lining is more prone to erosion and discharge. Most doctors prescribe vaginal estrogen alongside a pessary after menopause to keep the tissue healthy. If erosions keep recurring, surgery may become the more comfortable option.

Is it safe to leave a pessary in for months?

Only under medical supervision. Space-filling pessaries are routinely left in for a few months between clinic cleanings. A device forgotten for years can embed and damage tissue, so keep to the review schedule you are given.

If the pessary works, do I still need surgery?

No. If you are comfortable, the tissue is healthy and you are happy managing it, there is no medical requirement to operate. Surgery is for women whose pessary fails, causes problems, or who want a permanent repair.

Keep reading

Related treatments and guides

• Uterine Prolapse Surgery — the uterus-preserving surgical alternative to a pessary
• Vaginal Ring (Pessary) Removal — moving from a device to a permanent repair
• Pessary vs Surgery for Pelvic Organ Prolapse: Which Is Better? — the broader comparison for all compartments
• Can Uterine Prolapse Be Treated Without Surgery? — pelvic floor training, lifestyle and estrogen alongside a pessary
• What Are the Stages of Uterine Prolapse? — know your stage before choosing
• Hysteropexy vs Hysterectomy for Uterine Prolapse: Which Is Better? — if you decide on surgery

Sources and medical review

• American College of Obstetricians and Gynecologists (ACOG) — guidance on pessary use for pelvic organ prolapse
• International Urogynecological Association (IUGA) — patient information on vaginal pessaries
• Te Linde's Operative Gynecology — non-surgical and surgical management of uterine prolapse

Next step

A consultation first. A decision only when you are ready.

Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.