Beauray Inc.
Ring Pessary: Uses, Sizes, Fitting and Insertion Guide
A ring pessary is one of the most widely recognized types of vaginal pessary. It is a removable support device that a qualified healthcare professional may consider for pelvic organ prolapse or certain forms of stress urinary incontinence. Ring pessaries are available in different designs and sizes, and appropriate assessment and fitting are essential.
What is a ring pessary?
A ring pessary is a flexible, usually silicone device placed in the vagina to provide internal support. Depending on the model, it may be supplied with or without a supporting membrane, or with a knob intended to provide additional support near the bladder neck. The ring shape is often the first shape patients recognize when they hear the word “pessary,” although many other pessary shapes exist.
Why do patients search for a pessary?
People commonly search for pessary information after hearing about a nonsurgical support option for pelvic organ or uterine prolapse, stress urinary incontinence, or cervical support during pregnancy. These are different clinical needs and may involve different pessary designs. A ring pessary used for prolapse is not automatically appropriate for urinary symptoms or cervical insufficiency.
- Pelvic organ or uterine prolapse: a clinician may assess whether a support pessary is appropriate.
- Stress urinary incontinence: an incontinence ring or ring with knob may be considered after clinical assessment.
- Cervical insufficiency or a short cervix: specialist-managed cervical pessaries, including cup/cerclage designs and historically Hodge designs, are distinct from routine ring pessaries. Read the cervical pessary guide.
Ring pessary for prolapse
A ring pessary may be considered to support symptoms associated with pelvic organ prolapse, including certain presentations of uterine prolapse or cystocele. Suitability depends on anatomy, symptoms, prolapse characteristics and the clinician’s assessment. Learn more in the pessary for prolapse guide.
Ring pessary with support vs without support
A ring without support has an open centre. A ring with support includes a membrane across the centre. The supporting membrane may provide additional support in some clinical situations, but the correct design cannot be selected from an online description alone. Product design and indications must be checked against the current manufacturer documentation.
Ring with knob pessary
A ring with knob pessary includes a raised component designed to provide support near the urethra or bladder neck. A healthcare professional may consider this design for a patient with stress urinary incontinence, sometimes alongside mild prolapse, when consistent with the product’s authorized indication.
Ring pessary sizes and size chart
Ring pessaries are manufactured in multiple diameters. The number printed on a pessary does not replace a clinical fitting. A trained professional typically evaluates the vaginal dimensions, tries an appropriate fitting model, and checks comfort and retention during movement, coughing, bearing down and voiding.
| Size | #0 | #1 | #2 | #3 | #4 | #5 | #6 | #7 | #8 | #9 |
|---|---|---|---|---|---|---|---|---|---|---|
| Without support SKU | R#0 | R#1 | R#2 | R#3 | R#4 | R#5 | R#6 | R#7 | R#8 | R#9 |
| With support SKU | Rs#0 | Rs#1 | Rs#2 | Rs#3 | Rs#4 | Rs#5 | Rs#6 | Rs#7 | Rs#8 | Rs#9 |
| Diameter (mm) | 44 | 50 | 57 | 63 | 69 | 75 | 82 | 88 | 95 | 101 |
| Diameter (inch) | 1.75 | 1.95 | 2.25 | 2.50 | 2.70 | 2.95 | 3.25 | 3.45 | 3.75 | 4.00 |
How is a ring pessary fitted?
Pessary fitting is individualized. The objective is a device that remains comfortably in position and provides the intended support without interfering with normal activities. More than one size or style may need to be assessed. Follow-up is important because symptoms, anatomy and fit may change.
Ring pessary insertion and removal
Insertion, removal and care instructions vary by model and patient. A clinician should demonstrate the technique and establish an appropriate follow-up and cleaning plan. Patients should not select a size or attempt first-time fitting solely from online instructions.
Common concerns
- Discomfort, pressure or pain
- A pessary that moves or falls out
- Difficulty urinating or emptying the bowel
- Bleeding, irritation, unusual discharge or odour
- Difficulty removing or reinserting the device
A patient experiencing concerning or persistent symptoms should contact their healthcare professional. Urgent symptoms require prompt medical assessment.
Other pessary types
If a ring design does not provide appropriate support, a clinician may consider another shape. Beauray’s professional product information includes Gellhorn, Cube, Donut, Cup, Hodge and other pessary types.
Product information in Canada
Beauray provides product information and inquiry support for healthcare professionals in Canada. Product availability, indications, licensing and regulatory status must be confirmed for each device before any supply discussion. Contact Beauray to request current product documentation.
Medical information notice: This page provides general educational and product information and is not medical advice. Pessary selection, sizing, insertion and follow-up should be directed by a qualified healthcare professional.