This months pessary lesson is the Shaatz Pessary.
For whom is the Shaatz pessary suitable for ?
The Shaatz pessary is ideally recommended for women who have a first or second degree prolapse (mild – moderate) which has complications of a mild cystocele.
I can’t retain a ring pessary so will this help?
Possibly, as the Shaatz is ideal for the patient that has a shallow pubic notch.
How does this work with someone that has very little pubic notch to support a pessary?
The Shaatz uses the levator muscles to hold it in place, so good pelvic muscle structure is a great help in this case.
Can I build up muscle structure?
Through regular kegel exercises and physiotherapy, women have built up a good pelvic floor muscle strength leading to good structure.
I have pressure sores on the pubic notch can I use the Shaatz?
Yes it is designed to alleviate pessary pressure on the pubic notch.
What are the holes in the pessary for?
The holes in the pessary allow for drainage of any vaginal fluids.
How do I know what size to use?
Your doctor or women’s health physiotherapist will be able to measure you. The width of the vaginal vault helps determine the size of the Shaatz needed. The Shaatz requires a roomy vaginal vault.
With my uterine prolapse, will the cervix push out the Shaatz?
No, if the shaatz is positioned correctly then there shouldn’t be any movement of this pessary as the cervix rests behind the disc of the pessary.
Can the Shaatz restrict bowel movements?
It is possible if the shaatz is the wrong size or in the wrong position. But it could also restrict if you have a rectocele regardless.
How do I remove the Shaatz pessary?
Insert one finger into the large hole to bring the pessary down toward the introitus (opening of the vagina) . Turn the pessary so that the rim is almost parallel to the introitus. With one or two fingers of the other hand, press down on the perineum and slide the pessary out.
What about cleaning the Shaatz?
Its like any other pessary, wash under clean water, you can boil it, autoclave it but its just as easy to wash well. If you use soap remember to remove ALL soap residue before re-inserting. Do not towel dry as tiny fibres can get stuck to the silicone and may cause infection. Just air dry or even reinsert when wet.