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                                            Safety Information Article
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      Pessary/Pessaries 

Pessary/Pessaries
A pessary is a relatively small medical device that is inserted into the vagina or rectum and held in place by the pelvic floor musculature. In some instances, a pessary may contain metal to permit forming it into a shape to facilitate proper fit and retention.

Typically, the pessary is a firm ring or similar structure that presses against the wall of the vagina and urethra to help decrease urinary leakage or other condition. Indications for the pessary include pelvic support defects, such as uterine prolapse and vaginal prolapse, as well as stress urinary incontinence. 

MRI Information. 
A wide variety of pessary styles exist, including those made entirely from nonmetallic, nonconducting materials (e.g., plastic, silicone, or latex) as well as those that have metallic components. Obviously, pessaries made from nonmetallic, nonconducting materials pose no problems for patients undergoing MR procedures. However, pessaries that have metallic components may cause substantial artifacts and/or may pose risks to patients undergoing MR examinations. 

As such, a patient with a pessary that contains metal should be given additional consideration prior to the MR examination. Notably, to date, there is no report of injury or other significant problem related to performing MR examinations in patients with these devices. 

REFERENCES
Brubacker L. The vaginal pessary. In: Friedman AJ, ed. American Urogynecologic Society Quarterly Report 1991;9(3).

Davila GW. Vaginal prolapse: management with nonsurgical techniques. Postgrad Med 1996;99: 171-6,181,184-5.

Deger RB, Menzin AW, Mikuta JJ. The vaginal pessary: past and present. Postgrad Obstet Gynecol 1993;13:1-8.

Komesu YM, Ketai LH, Rogers RG, Eberhardt SC, Pohl J. Restoration of continence by pessaries: magnetic resonance imaging assessment of mechanism of action. Am J Obstet Gynecol. 2008;198(5):563.e1-6. 

Miller DS. Contemporary use of the pessary. In: Sciarra JJ, ed. Gynecology and obstetrics. Revised 1997 ed. Philadelphia: Lippencott-Raven, 1997:1-12.

Zeitlin MP, Lebherz TB. Pessaries in the geriatric patient. J Am Geriatr Soc 1992;40:635-9.



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