Pelvic Organ Prolapse · Treatment

Vaginal Ring (Pessary) Removal and What Comes Next

Vaginal ring removal means taking out a pessary, the silicone support device used to hold up a pelvic organ prolapse, and deciding what should replace it. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo removes the pessary in a few minutes without anesthesia, treats any irritated or ulcerated tissue, re-examines the prolapse once the walls have rested, and then discusses the options: a different pessary, pelvic floor training, or a uterus-preserving native-tissue repair.

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.

• Procedure time: removal takes a few minutes during a clinic visit
• Anesthesia: none needed for removal; a lubricant or local anesthetic gel for sore tissue
• Hospital stay: none
• Common reasons for removal: discomfort, discharge or odor, bleeding or erosion, the ring slipping out, difficulty with self-care, wanting a permanent solution
• After removal: prolapse re-staged (POP-Q 0 to 4) once the vaginal walls have rested; vaginal estrogen if tissue is thin or ulcerated
• Next steps offered: refit, supervised pelvic floor training with EMS device, or native-tissue hysteropexy and posterior repair with same-day discharge
• Performed by: Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist

What is a pessary and why is it removed?

A pessary is a flexible silicone device, most often a ring, placed in the vagina to hold a prolapsed uterus, bladder or rectum in position. It is a long-standing, non-surgical way to control prolapse symptoms and suits women who prefer to avoid surgery, who are not fit for it, or who want to delay it. Rings are usually changed and cleaned every few months, either by the woman herself or at a clinic.

Removal becomes a question when the ring stops working well or causes problems of its own. Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD. We fit, review and remove pessaries, and because we also perform uterus-preserving prolapse surgery, we can lay out every option for what comes next.

Who should consider pessary removal?

• The ring falls out when you strain, cough or open your bowels, meaning the size or type no longer fits.
• You have persistent discharge, odor or spotting; the ring may be rubbing or the vaginal wall may be ulcerated.
• You feel pressure, pain or difficulty urinating or passing stool with the ring in place.
• Removing, cleaning and reinserting it yourself has become difficult, and frequent clinic visits are a burden.
• You are sexually active and the type of pessary you have interferes with intercourse.
• You have decided you would rather have the prolapse repaired than manage it with a device for life.
• Your doctor has asked you to remove it before surgery so the tissue can recover.

A pessary that is comfortable, stays in and causes no discharge does not need to be removed just because time has passed; many women use one for years. The question is whether it is still the best option for you. Our guide Pessary vs Surgery for Pelvic Organ Prolapse compares the two paths.

How Somssi removes a vaginal ring

Removal

Removal is a simple clinic procedure. Dr. Yoon hooks a finger under the rim, folds the ring and withdraws it gently; a water-based lubricant or anesthetic gel is used if the tissue is sore. It takes a few minutes and needs no anesthesia. A ring that has been in place for a long time can be tight or stuck to inflamed tissue; in that case we soften the tissue with vaginal estrogen for a couple of weeks and try again rather than force it.

Examination of the vaginal walls

Once the ring is out, we inspect the vagina for pressure marks, ulcers, bleeding points or granulation tissue, and check for vaginitis or discharge. Ulcerated areas are treated with vaginal estrogen cream and the pessary is kept out until they have healed. Persistent bleeding is investigated rather than assumed to be from the ring.

Re-staging the prolapse

A pessary holds tissue up, so the true degree of prolapse is only visible after the walls have had a few days to settle. We examine you standing and bearing down, record the POP-Q stage (0 to 4), measure total vaginal length and wall thickness, test the pelvic floor contraction and perform a pelvic ultrasound of the uterus and ovaries. We also check for stress incontinence, which a pessary can mask.

What comes next: your options

Refitting a different pessary

If the ring simply did not fit, a different size or shape may solve the problem. This is a good choice for women who are not candidates for surgery or who want to keep things non-surgical.

Pelvic floor training

For stage 1 or mild stage 2 prolapse with few symptoms, supervised pelvic floor exercises, sometimes with an EMS Kegel device, can keep symptoms manageable without any device inside. Lifestyle changes such as treating constipation and avoiding heavy lifting support this.

Uterus-preserving native-tissue repair

Many women remove their pessary because they want the problem fixed. Dr. Yoon repairs prolapse through the vagina with your own tissue: a hysteropexy lifts and fixes the descended uterus (about 2 to 4 centimeters in the clinic's experience), a culdoplasty closes the cul-de-sac, and a posterior colporrhaphy with pelvic floor restoration rebuilds the back wall and perineum using two-layer suturing without mesh. Surgery takes about an hour under sedation with same-day discharge, and intercourse resumes after 7 to 8 weeks. The clinic reported a 2026 series of 150 women with prolapse in which 74.7% chose uterus-preserving surgery and 85.3% reported better quality of life. Full details are on the uterine prolapse surgery page.

Hospital-based surgery

If re-staging shows stage 3 to 4 prolapse, a large bladder prolapse or significant stress incontinence, a hospital operation may be the safer route, and we will coordinate the referral.

Anesthesia, duration and hospital stay

Pessary removal and refitting need no anesthesia and no hospital stay. If you proceed to native-tissue repair, the operation takes about 50 minutes to one hour under sedation plus long-acting local anesthesia, or local alone if you prefer, and you go home the same day once you have urinated.

Timeline after removal

Results and what to expect

Irritation, discharge and odor from a poorly fitting ring usually settle within one to two weeks of removal, faster with vaginal estrogen. Prolapse symptoms will return once the support is gone, which is expected and is why we plan the next step before you leave. Women who proceed to repair typically find the heaviness and bulge are gone within days of surgery, although results vary with stage and tissue quality.

Risks and how we reduce them

• Discomfort or minor bleeding during removal: reduced with lubricant, anesthetic gel and, for stuck rings, a short course of estrogen first.
• Unhealed ulcers: we keep the ring out until the wall has healed and do not operate on inflamed tissue.
• Return of prolapse symptoms: inevitable without support; we schedule the next step promptly.
• Hidden stress incontinence: leakage can appear after removal; we test for it so it is not a surprise after surgery.
• Surgical risks if you proceed to repair: bleeding, infection, rectal or cul-de-sac injury, pain with intercourse, recurrence and anesthesia reactions, reduced by careful technique and realistic selection.

Why international patients choose Somssi

Women visiting from abroad often have a pessary fitted at home but want a specialist opinion on whether a definitive repair is possible without hysterectomy. We can review your records in English before you travel, remove and re-stage in one visit, and, if you choose surgery, operate within days with same-day discharge. The clinic is 100 meters from Gangnam Station Exit 1 and has been registered for foreign patients with the Ministry of Health and Welfare since 2011. See international patients or contact us.

Questions patients ask

Frequently asked questions

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

See the full FAQ →

Does pessary removal hurt?

Usually not. The ring is folded and withdrawn in a few seconds with lubricant. If the vaginal wall is dry or ulcerated, removal can sting, so we use anesthetic gel and, for a ring that has been left in a long time, a short course of vaginal estrogen first to soften the tissue.

How long should I wait after removal before surgery?

Typically two to six weeks. The vaginal wall needs to heal from any pressure marks, and the prolapse needs to be examined without the ring so the repair is planned on the true anatomy. If there is no ulceration, surgery can be scheduled sooner.

Can I remove my pessary myself?

Many women remove, clean and reinsert a ring pessary themselves after being taught. If it has become difficult, if it hurts, or if you notice bleeding or odor, let us do it and check the tissue. Other pessary shapes, such as Gellhorn types, generally need clinic removal.

Is a pessary a long-term solution?

It can be. Some women use one comfortably for years with regular checks. Others find discharge, erosion or slipping make it a nuisance, and over time many choose repair. Neither path is wrong; the decision depends on your age, health, sexual activity and how much the device intrudes on your life.

Will I leak urine after the ring is removed?

Possibly. A pessary can hold the urethra in a position that prevents leakage, so stress incontinence sometimes appears once it is out. We test for this at the re-staging visit, because it affects what kind of repair, if any, we recommend.

Can the prolapse be repaired without removing my uterus?

In most cases, yes. Dr. Yoon's standard operation is a hysteropexy that lifts and fixes the uterus together with native-tissue repair of the vaginal walls and perineum, without mesh. Advanced stage 3 to 4 prolapse may need a hospital-based approach, and we will tell you honestly which group you are in.

Keep reading

Related treatments and guides

• Pessary vs Surgery for Pelvic Organ Prolapse: Which Is Better? — weighing the two paths
• Pessary for Uterine Prolapse: Does It Work? — what a ring can and cannot do
• Can Uterine Prolapse Be Treated Without Surgery? — non-surgical options after removal
• What Are the Stages of Pelvic Organ Prolapse? — how we re-stage after removal
• Uterine Prolapse Surgery — the uterus-preserving repair
• Pelvic Organ Prolapse Repair — when the rectum or cul-de-sac is involved
• International patients — visiting from abroad

Sources and medical review

• American College of Obstetricians and Gynecologists (ACOG) — patient guidance on pessaries and pelvic organ prolapse.
• International Urogynecological Association (IUGA) — patient information on vaginal pessaries.
• Te Linde's Operative Gynecology (textbook) — nonsurgical and surgical management of pelvic organ 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.