Management of the neglected vaginal ring pessary.

We present two cases of vaginal pessaries left in situ for prolonged periods and subsequent impaction that were managed differently. One was partially epithelialized and removed in the outpatient clinic by a new technique whereby the ring pessary was divided by a bone-cutter and passed through the epithelial tunnel without anesthesia. The second, which was a completely epithelialized metal ring pessary, was removed under anesthesia. Resulting fibrosis can cure the prolapse.