Pessary use and management for pelvic organ prolapse.

Pessary is a low-risk and effective non-surgical treatment option for pelvic organ prolapse. Indications for pessary include symptomatic prolapse, if surgery is not desired or recommended, and use as a diagnostic tool to predict surgical outcomes. Evidence for pessary selection and management is incomplete so trial and error, expert opinion, and experience remain the best guides for use and management of the pessary. With proper training and understanding of pessary management, most patients can be successfully fitted and taught to manage the pessary either for short- or long-term relief of symptoms. Patient satisfaction is high making pessary an important tool in treating prolapse.