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Pessary, non rubber, any type

HCPCS code

Name of the Procedure:

  • Common Name(s): Non-Rubber Pessary
  • Medical Term: Pessary, non-rubber, any type (HCPCS Code: A4562)


A non-rubber pessary is a medical device inserted into the vagina to provide support for pelvic organ prolapse or to manage urinary incontinence.


  • Medical Conditions: Pelvic organ prolapse, urinary incontinence.
  • Goals/Expected Outcomes: To alleviate symptoms of pelvic organ prolapse and prevent urinary leakage, thereby improving the quality of life for the patient.


  • Symptoms/Conditions: Feeling of heaviness or pressure in the pelvis, urinary incontinence, discomfort during sexual activity.
  • Patient Criteria: Women diagnosed with pelvic organ prolapse or urinary incontinence who are not suitable candidates for surgery or prefer a non-surgical option.


  • Pre-Procedure Instructions: Usually, no specific preparation such as fasting is required. Patients may be asked to empty their bladder before the procedure.
  • Diagnostic Tests: Pelvic exam, assessment of the degree of prolapse and incontinence.

Procedure Description

  1. Examination: The healthcare provider performs a pelvic exam.
  2. Fitting: The appropriate size and type of pessary are selected.
  3. Insertion: The pessary is folded and gently inserted into the vagina.
  4. Adjustment: The provider ensures the pessary is comfortable and provides the needed support.
    • Tools/Equipment: Non-rubber pessary of a specific type and size.
    • Anesthesia/Sedation: Typically, none required.


  • Typical Time: 10-15 minutes.


  • Location: Outpatient clinic or physician's office.


  • Healthcare Professionals Involved: Gynecologists, primary care physicians, or nurse practitioners.

Risks and Complications

  • Common Risks: Vaginal irritation, discomfort, increased vaginal discharge.
  • Rare Risks: Infection, ulceration of vaginal tissues. Management includes removal of the pessary and treatment with antibiotics or ointments if necessary.


  • Expected Benefits: Immediate relief from symptoms such as pressure, incontinence, or discomfort.
  • Timeframe: Benefits can be realized immediately upon proper placement and fitting.


  • Post-Procedure Care: Regular cleaning and periodic follow-up visits to check fit and condition of the pessary.
  • Recovery Time: No downtime required; normal activities can typically be resumed immediately. Follow-up appointments as advised by the healthcare provider.


  • Other Treatment Options: Pelvic floor exercises (Kegels), surgical repair, use of a rubber pessary.
  • Pros and Cons:
    • Pelvic Floor Exercises: Non-invasive but takes time to see results.
    • Surgical Repair: Potentially permanent solution but involves risks of surgery and longer recovery.
    • Rubber Pessary: Similar function but may cause allergic reactions in those sensitive to rubber.

Patient Experience

  • During Procedure: Minimal discomfort during insertion.
  • After Procedure: Some women might experience mild pressure or vaginal discharge, which usually resolves with time. Pain management typically involves over-the-counter pain relievers if needed. Regular follow-up ensures ongoing comfort and effectiveness.

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