When to use a pessary?

Indications to use a pessary include: 

• relieve symptoms of pelvic organ prolapse 
• relieve symptoms of stress urinary incontinence 
• unmask latent/occult/masked stress urinary incontinence pre-operatively
• temporarily treat symptoms while awaiting surgery or still wanting to expand family
• not appropriate for surgery
• have failed a previous surgery
• urinary urgency
• difficulty emptying bladder or bowels
• sexual activity and satisfaction 

When NOT to use pessaries?

Do not use pessaries when you experience

• Undiagnosed bleeding
• Severe vaginal atrophy
• Active vulvar, vaginal or urinary tract infection
• Ulceration or lacerations of the cervix, vagina
• Uncontrolled diabetes
• Cancer of the vagina, vulva, uterus, or bladder
• Active inflammatory disease (pelvic inflammatory disease)
• Ano-perineal lesions associated with Chron’s Disease
• Silicon allergy
• Non-compliance (person known to not follow recommendations and/or adhere to appointment schedule) 
• Gynecological surgery with mesh

What are the risks or side effects of pessary use?

A common side effect of pessary use is increased vaginal discharge, irritation or fissure at the introitus, small amount of blood on pessary, expulsion of the pessary with bearing down, discomfort during the trial or routine removal or insertion and new SUI or bladder and bowel urgency or retention.

Pessary Fitting

Pessary fittings in Ontario is a delegated act for physiotherapists which means we will require the permission of your physician or nurse practitioner which our clinic will arrange. Gynecologists, nurse practitioners or pelvic health physiotherapists fit pessaries. Pessary fittings would be covered under your private health insurance or physiotherapy coverage. We can not accept OHIP for this service. Your extended health care plan often covers the cost of a pessary which is $150.

Call Berton Physiotherapy & Chiropractic to book your pessary fitting appointment. Appointments are only booked on Monday or Tuesday to ensure the clinic is open to help you with any of your concerns during your pessary trial. 

Pelvic Health Physiotherapy

Women and men can take advantage of pelvic health physiotherapy in Windsor, Ontario at Berton Physiotherapy & Chiropractic Clinic. Lana Berton, Physiotherapist, has extensive specialized training in pelvic floor rehabilitation.

This specialized physiotherapy is the first line of defence for a wide range of pelvic floor dysfunctions. Research by The Cochrane Collaboration in 2010 concludes that specialized training in pelvic floor rehabilitation should be considered prior to surgical consultation (specifically using internal examination and treatment). This is for symptoms of unusual urgency and mixed incontinence.

Three layers of muscles make up the pelvic floor. These form a sling that attaches the coccyx (tailbone) to the front and sides of the pelvis. The muscles wrap around the urethra, rectum and vagina.

Pelvic Organ Prolapse

Pelvic Organ prolapse is an anatomical support defect of the pelvic viscera. It may be resulted from a series of long-term failure of the supporting and suspension mechanism of the uterus and the vaginal wall. The defect in the supporting structures results in downward displacement of structures that are normally located adjacent to the vaginal vault. The generally terminology would be a uterine prolapse, cystocele, rectocele or enterocele. Causes of pelvic organ prolapse, according to the current research, include increasing age to menopause then plateaus, vaginal delivery and connective tissue disorders. 

What to expect during your first visit

Wondering what to expect on your first visit? Your pelvic assessment will be completed in a private room in a comfortable atmosphere.

Initial Evaluation

During the initial evaluation/interview, we will discuss your concerns, questions, issues, goals and education regarding pelvic floor function.

Physical Examination

Your physical examination may differ depending on the client’s needs but generally involves an internal vaginal and rectal exam. The pelvic floor muscles will be assessed for pain, tone, strength, and endurance. At that time, a treatment plan is provided, tailored to your specific needs. As well, as instructional/educational handouts or audio. Treatments may include internal manual therapy for the pelvic floor, joint and soft tissue mobilizations, stretches, strengthening exercises, biofeedback, and electrical muscle stimulation.

Lana Berton has received extensive pelvic floor physiotherapy education with Pelvic Health Solutions and is listed as a qualified provider for both women and men at PelvicHealthSolutions.ca.

Lana Berton’s education includes:

• 9th Pelvic Health Solutions Symposium – 2022
• Beyond The Pelvis: Exercise For The Whole Body and The Everyday Person – Teresa Waser – 2023
• Bowel and Bladder Treatment of the Client with Neurologic Dysfunction – Carina Siracusa – 2021
• CBT Skills for Distressing Physical Symptoms – Lara Desrosiers – 2019
• Cesarean Birth & Rehabilitation – Jaclyn Seebach – 2022
• Diastasis Rectus Abdominis & the Implications for Low back & Pelvic Health: What’s the Solution? – Diane Lee – 2020
• Gastrointestinal Disorders & The Pelvic Floor – 2015
• Introductory Electrical Stimulation for Pelvic Health – Fiona Rogers – 2020
• Level 1: The Physiotherapy Approach to Female and Male Urinary Incontinence – 2015
• Level 2: The Physiotherapy Approach to Female and Male Pelvic Pain – 2015
• Level 3: Clinical Skills For Treating Pain – 2015
• Menopause: An Integrative Approach for Physiotherapists – Michelle Lyons – 2022
• Mobilization of Visceral Fascia: The Reproductive System – Ramona Horton – 2018
• Mobilization of Visceral Fascia: Urinary System – Ramona Horton – 2018
• Mobilization of Visceral Fascia: GI System – Ramona Horton – 2020
• Oncology & the Pelvic Floor – 2022\
• Pelvic Girdle Pain & The Pelvic Floor – 2016
• Pelvic Neurodynamics – 2016
• Pregnancy & The Pelvic Floor – 2016
• Special Topics in Pelvic Genital Rehabilitation: Post Vasectomy, Circumcision, Hernia Repair & Penile Assessment & Treatment – Holly Tanner – 2021
• The Evil Triplets of Pelvic Pain (and their friends…) – Michelle Lyons – 2019
• The Fascial Connection To Restore Movement – 2016
• The Female Athlete – Antony Lo – 2017
• The Male Pelvic Health Masterclass – Michelle Lyons – 2019
• The Running Athlete – Kate Mihevc Edwards – 2023

If you wonder if you are a candidate for pelvic health physiotherapy please call and speak personally with Lana Berton.

Is Pelvic Health Physiotherapy For You?

For more information or to book an appointment call and speak personally with Lana Berton at Berton Physiotherapy and Chiropractic today at 519-966-8200

Berton Physiotherapy & Chiropractic

555 Tecumseh Rd. E.
Windsor, ON
N8X 2S1

Phone: (519) 966-8200
Fax: (519) 966-0990

Mon – Thu: 9 am – 6:00 pm
Fri: 9 am – 3:00 pm

HipTrac™ is a first-in-class light-weight, portable device that replicates and complements the manual therapy techniques of long axis hip traction. We are proud to be one of the first in Canada to incorporate this device into our patient’s treatment plans. Health practitioners interested in using HipTrac™ can find out more by visiting HipTrac.ca.

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