Ring and Cube Pessaries for Prolapse: How Pelvic Floor Physiotherapy Can Help Women

Pelvic organ prolapse is incredibly common — yet many women feel uncomfortable talking about it or are unsure where to seek support. For many women, pessaries can provide significant relief from symptoms and help improve comfort, confidence, and quality of life. Pelvic Floor Physiotherapists play an important role in assessing, fitting, and managing pessaries as part of a holistic and evidence-informed women’s health approach.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when the pelvic floor muscles and connective tissues are unable to fully support the pelvic organs.

This may involve:

• bladder prolapse (cystocele)

• bowel prolapse (rectocele)

• uterine prolapse

• vaginal vault prolapse

  
  

Women may notice symptoms such as:

• pelvic heaviness or dragging

• a vaginal bulge sensation

• bladder urgency or leakage

• difficulty emptying the bladder

• constipation or bowel emptying difficulties

• lower back discomfort

• pressure that worsens throughout the day

  
  

These symptoms are common, but they should not simply be accepted as a normal part of ageing or motherhood.

What Is a Pessary?

A pessary is a removable silicone device inserted into the vagina to help support pelvic organs and reduce prolapse symptoms.

Pessaries can often help women:

• feel more comfortable during daily activities

• return to exercise

• reduce pelvic pressure

• improve bladder or bowel symptoms

• avoid or delay surgery

• manage symptoms during postpartum recovery or menopause

  
  

Many women across South East Melbourne are surprised to learn that pessaries are a conservative, non-surgical management option for prolapse.

What Is a Ring Pessary?

A ring pessary is one of the most commonly used pessaries for mild to moderate prolapse.

Ring pessaries are generally:

• soft and flexible

• comfortable for everyday wear

• suitable for bladder or uterine prolapse

• easier for some women to self-manage

  
  

Many women use ring pessaries to support:

• walking and exercise

• lifting

• standing for long periods

• postpartum recovery

• symptom management during menopause

  
  

A pelvic floor physiotherapist can help determine whether a ring pessary is appropriate based on individual symptoms, prolapse type, lifestyle, and pelvic floor assessment findings.

What Is a Cube Pessary?

Cube pessaries are often used for women with more significant prolapse symptoms or when additional support is required.

Unlike ring pessaries, cube pessaries use gentle suction to provide support within the vaginal walls.

Cube pessaries may be recommended for:

• more advanced prolapse

• women experiencing significant vaginal heaviness

• prolapse symptoms during exercise

• women awaiting surgical review

• cases where ring pessaries do not provide enough support

  
  

How Can a Pelvic Floor Physiotherapist Help?

Pelvic Floor Physiotherapists are specially trained to assess and manage pelvic floor dysfunction and prolapse.

A pelvic floor physiotherapy assessment will include:

• discussion of symptoms and goals

• pelvic floor muscle assessment

• prolapse assessment

• bladder and bowel history

• movement and breathing assessment

• lifestyle and exercise considerations

  
  

This comprehensive assessment helps determine:

• whether a pessary may be appropriate

• which type of pessary may suit best

• the correct size and fit

• whether additional pelvic floor rehabilitation may help

Pessary Fitting and Ongoing Management

Finding the correct pessary fit is important for both comfort and effectiveness.

A pelvic floor physiotherapist can assist women with:

• pessary fitting

• education on insertion and removal

• self-management strategies

• monitoring comfort and symptoms

• exercise guidance

• pelvic floor rehabilitation alongside pessary use

  
  

Women are often reassured to learn that pessary fitting is tailored to the individual and may involve trialling different sizes or styles. The goal is to help women feel comfortable, supported, and confident in daily life.

A Holistic Approach to Prolapse Management

Pelvic organ prolapse management is not only about supporting the pelvic organs.

Many women also benefit from:

• pelvic floor muscle rehabilitation

• breathing and pressure management strategies

• constipation management

• strength and exercise guidance

• nervous system support

• education around lifting and movement patterns

  
  

Supporting Women Across South East Melbourne

Samara Nanayakkara is passionate about helping women across Rowville, Mulgrave, Wheelers Hill, Glen Waverley, Mount Waverley, Oakleigh, Scoresby, Knox, Surrey Hills, Burwood, and Notting Hill feel informed and supported in managing prolapse symptoms. With compassionate, evidence-informed pelvic floor physiotherapy care, women can better understand their bodies, explore conservative treatment options, and regain confidence in movement and daily life. Because prolapse symptoms are common — but women deserve support, education, and personalised care.