Impaction after partial expulsion of a neglected pessary.

BACKGROUND

Vaginal pessaries are effective for treating pelvic organ prolapse, and severe complications are rare. We describe an exceptional case of pessary impaction with partial expulsion.

CASE

An elderly woman had mild discomfort from a pessary protruding through the perineal skin. The pessary was cut, removed, and the perineum healed uneventfully.

CONCLUSION

Negligence of vaginal pessaries may result in migration to the bladder or to the rectum. This case of perineal expulsion was eventually easily treated. Although no evidence-based guidelines for pessary care exist, this rare manifestation suggests the need for follow-up on a regular basis.