Fitting and insertion of pessary or other intravaginal support device
CPT4 code
Name of the Procedure:
Fitting and Insertion of Pessary or Other Intravaginal Support Device
Common name(s): Pessary fitting, intravaginal support device insertion.
Technical/medical terms: Vaginal pessary fitting, prolapse support device insertion.
Summary
A pessary or intravaginal support device is a medical tool inserted into the vagina to support the pelvic organs. This device can help manage conditions like pelvic organ prolapse and urinary incontinence by providing necessary support and alleviating symptoms.
Purpose
The procedure addresses pelvic organ prolapse and urinary incontinence.
Goals: To provide structural support to the pelvic organs, alleviate discomfort, and improve the quality of life for patients with pelvic support issues.
Indications
- Symptoms of pelvic organ prolapse (e.g., a feeling of heaviness or bulge in the vagina)
- Urinary incontinence
- Inability or unwillingness to undergo surgical treatment
- Postpartum pelvic floor weakness
Preparation
- No specific fasting required
- Patients may need a gynecological exam before fitting
- Ensure a full bladder for certain types of pessaries (as instructed by the doctor)
Procedure Description
- The patient lies on an examination table in a position similar to a pelvic exam.
- A healthcare professional inserts a lubricated pessary into the vagina.
- The device is positioned to support the pelvic organs, ensuring comfort and effectiveness.
- Different sizes may be tried to find the best fit.
- Instructions on care, maintenance, and removal of the pessary will be provided.
Tools: Various sizes and shapes of pessaries, lubricating gel.
Anesthesia: Typically not required but can be used for comfort if necessary.
Duration
The procedure typically takes around 15-30 minutes.
Setting
Performed in a healthcare provider's office, outpatient clinic, or gynecology department.
Personnel
- Gynecologist or trained healthcare provider
- Nurse or medical assistant for support
Risks and Complications
- Vaginal irritation or ulcers
- Infection
- Difficulty in removing the device
- Discomfort or pain
Benefits
- Relieves symptoms of pelvic organ prolapse and urinary incontinence
- Improves overall quality of life
- Non-surgical and low-risk procedure
- Immediate symptom relief in many cases
Recovery
- Minimal recovery time; patients can usually resume normal activities immediately
- Instructions on cleaning and maintaining the pessary
- Regular follow-up appointments to check the pessary position and vaginal health
Alternatives
- Pelvic floor exercises (e.g., Kegel exercises)
- Surgical options (e.g., pelvic organ prolapse surgery)
- Lifestyle modifications (e.g., weight management, avoiding heavy lifting) Pros and cons: Non-surgical options like exercises may take longer to show results while surgery has a longer recovery time and higher risks.
Patient Experience
Patients might feel mild discomfort or pressure during insertion. Post-procedure, most patients report minimal pain. Pain management: Over-the-counter pain relievers if needed. Comfort measures: Patient education on device maintenance and use.